Clozapine Withdrawal-Induced Catatonia with Overlapping Features of Neuroleptic Malignant Syndrome: a Case Report.

BACKGROUND

Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, and abrupt discontinuation can lead to severe neuropsychiatric destabilization, including withdrawal catatonia. High-potency dopamine D2 receptor antagonists may further precipitate neuroleptic malignant syndrome (NMS), a condition with substantial clinical overlap with malignant catatonia.

OBJECTIVE

This report follows CARE guidelines to provide a structured and transparent description of a complex case involving abrupt clozapine withdrawal and rapid antipsychotic transition.

CASE PRESENTATION: This report describes a male patient with schizophrenia who developed malignant catatonia with overlapping NMS features following abrupt clozapine withdrawal and initiation of fluphenazine.

CONCLUSION

The case underscores the importance of cautious antipsychotic transitions and early recognition of catatonia and NMS.