A report associated catatonia with a missed long-acting antipsychotic dose and described improvement during high-dose benzodiazepine care. It did not prove withdrawal as the sole cause.
The reported course
A forty-three-year-old man with schizophrenia and other psychiatric diagnoses developed catatonia after missing paliperidone. His condition progressed to malignant catatonia.
ECT was considered but deferred because it was unavailable locally and because of family wishes. Benzodiazepine treatment was escalated, followed by slow recovery, a prolonged admission, and a planned taper. Paliperidone was resumed after discharge.
Attribution and alternatives
The temporal relationship led the authors to discuss withdrawal-related catatonia. A single case cannot establish the frequency or mechanism of that association or exclude contributions from the underlying illness and other care.
The absence of ECT is not a comparison showing benzodiazepines were equally effective or preferable. Resource and family factors shaped the actual treatment sequence.
Interpreting the record
Document missed treatment, symptom onset, autonomic changes, dose escalation, and recovery separately. High doses in this particular syndrome should not be generalized to routine anxiety or agitation. The report illustrates management under constraints, while leaving comparative treatment effects and the exact cause of deterioration uncertain.
Source paper
Original analysis of the supplied journal article, identified as PMC13242938.
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