Clinical Course and Management of Drug-Induced Catatonia and Paranoid Behavior in an Adolescent

ABSTRACTA 19-year-old Hispanic male with past psychiatric history of illicit drug use was brought by his mother to the emergency room of a tertiary care hospital with altered mental status. According to patient's mother his paranoid symptoms consisted of increased suspiciousness towards his friends and other family members, but were not to the extent for him to seek out any medical help. Clinical course and management of this patient, who later progressed to full blown catatonia, is described in this report. Patient had paradoxical disinhibition when treated with benzodiazepine, limiting treatment options. Patient's mother would not consent for ECT treatment after which Olanzapine was selected to manage his catatonic symptoms. This patient's preexisting paranoid ideations and catatonia were stabilized successfully with a few days of olanzapine with significant decrease in Bush-Francis Catatonia Score. Initial catatonia score of 14 points at baseline decreased to 3 points after 20 days of inpatient managem...