Key result
Intravenous haloperidol linked to neuroleptic-induced catatonia, resolving upon discontinuation and starting lorazepam.
Case Report (n=2)
Intravenous haloperidol can induce severe catatonia in patients with chronic psychotic disorders, which resolves with prompt discontinuation and lorazepam treatment.
IV haloperidol may warrant catatonia monitoring in psychotic disorders; Level 5 evidence leaves open incidence and risk factors.
PURPOSE: To report the cases of 2 hospitalized patients with chronic psychotic disorders who developed neuroleptic-induced catatonia (NIC), a catatonic-extrapyramidal syndrome occurring after administration of a D2-receptor antagonist, and delineate the importance of prompt recognition and treatment. METHODS: Two patients with chronic psychotic disorders were admitted to the hospital for unstable medical conditions at which time their maintenance antipsychotic therapy was discontinued. Following administration of intravenous haloperidol, both patients developed catatonic and extrapyramidal signs. Both patients developed catatonia, rigidity, hyperthermia, leukocytosis, and elevations in creatine kinase. In both cases, the patients met the criteria for catatonia as evidenced by motoric immobility, stupor, mutism, and negativism. The syndrome resolved within a few days of stopping haloperidol and initiation of lorazepam. CONCLUSION: Neuroleptic-induced catatonia is underrecognized and can lead to potentially severe complications, although early recognition and treatment may prevent progression and complications. Previous reports do not underscore the importance of prompt recognition and treatment.
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Gugger et al. (2011) conducted a case report in Chronic psychotic disorders (n=2). Intravenous haloperidol was evaluated on Development of neuroleptic-induced catatonia. Administration of intravenous haloperidol in two hospitalized patients with chronic psychotic disorders led to neuroleptic-induced catatonia, which resolved upon stopping haloperidol and starting lorazepam.
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