'Catatonia' due to disulfiram toxicity
C. M. Fisher
Neurology Service, Massachusetts General Hospital, Boston 02114.
In an alcoholic patient, catatonia developed while he was receiving
disulfiram (Antabuse). Resolution of the question whether his state was
classically catatonic required a detailed review of the literature on the
subject. The conclusion reached is that the original definition still holds
for psychiatric illness, but application of the term to neurological and
metabolic states has often been based on imprecise criteria and failure to
consider akinetic mutism and extrapyramidal motor disturbances as factors.
The action of disulfiram as an inhibitor of dopamine beta hydroxylase
provides a possible mechanism for the cerebral toxic effect, but
nonetheless the various interpretations remain largely speculative.
