The Treatment of Clozapine-Withdrawal Delirium withElectroconvulsive Therapy

Clozapine, a commonly used atypical antipsychotic, can precipitate a severe withdrawal syndrome. In this report, we describe acase of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developingneuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) wasinitiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromesof varied symptomatology treated with ECT. To our knowledge, the present case represents the first reported clozapine-withdrawaldelirium treated successfully with ECT.