Clozapine withdrawal syndrome; a case report

Garrido-Pinzás A.E.; Cruzalegui M.; Cabrejos Novoa C. · Psychiatry Research Case Reports (2025) · DOI: 10.1016/j.psycr.2025.100279

Resumen

Introduction: Abrupt clozapine discontinuation can trigger a rare withdrawal syndrome characterized by psychosis, serotonergic symptoms, catatonia, and cholinergic rebound symptoms. Case presentation: We report a 37-year-old woman with schizoaffective disorder who accidentally stopped clozapine abruptly, leading to severe psychomotor agitation, psychosis, catatonia, and dysautonomia, requiring hospitalization. Differential diagnoses, including neuroleptic malignant syndrome, were considered. Symptoms gradually improved upon reintroducing clozapine, confirming the diagnosis of clozapine withdrawal syndrome. Discussion: Clozapine withdrawal syndrome may be underdiagnosed. The most effective treatment is to restart clozapine; gradual tapering is preferred to avoid complications when discontinuation is necessary. Conclusion: Awareness of clozapine withdrawal is crucial for early diagnosis and treatment.

Instituciones: Universidad Peruana Cayetano Heredia