Benzodiazepine withdrawal delirium with catatonic features. Occurrence in patients with partial seizure disorders
P. Hauser, O. Devinsky, M. De Bellis, W. H. Theodore and R. M. Post
Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
We report the cases of 3 patients with medically intractable seizures in
whom withdrawal of treatment with a long-acting benzodiazepine (clorazepate
dipotassium, 2 patients; clonazepam, 1 patient) was followed by delirium
with catatoniclike features. While an increase in seizure frequency
occurred during withdrawal and prior to the onset of behavioral changes,
electroencephalograms did not show epileptiform activity during the
delirium. We compared these 3 patients with 10 others with intractable
seizures in whom antiepileptic therapy was withdrawn without subsequent
behavior changes. High-dose benzodiazepine therapy and a history of viral
encephalitis may be risk factors for withdrawal delirium.
