Catatonia and cannabis withdrawal: A case report

Subst Abus. 2016;37(1):188-9. doi: 10.1080/08897077.2015.1052869. Epub 2015 Aug 6.

Abstract

Background: Catatonia is a severe motor syndrome found in approximately 10% of all acute psychiatric hospital admissions. It can occur in various psychiatric diseases. The authors report the first case report of catatonia during cannabis withdrawal.

Case presentation: Mr. A, a 32-year-old man, reported to have smoked approximately 20 g of cannabis daily since the age of 11. Mr. A was incarcerated and was reported 3 weeks later to the medical department for having completely ceased talking and eating. At admission in the authors' department, the patient presented with classical catatonia symptoms (Bush-Francis Catatonia Rating Scale [BFCRS] score = 39/69). All laboratory results and brain magnetic resonance imaging (MRI) were normal. Six weeks after his admission and treatments by lorazepam and memantine, his BFCRS score was 0/69.

Discussion: This single case study highlights the previously underreported emergence of physical and motor symptoms following cannabis withdrawal. Pathophysiological aspects of abrupt cannabis cessation contributing to γ-aminobutyric acid (GABA)/glutamate balance dysregulation and to catatonia are discussed.

Keywords: Cannabis withdrawal; GABA/glutamate balance; catatonia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catatonia / complications*
  • Catatonia / diagnosis*
  • Catatonia / drug therapy
  • Excitatory Amino Acid Antagonists / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Lorazepam / therapeutic use
  • Male
  • Marijuana Abuse / complications*
  • Marijuana Abuse / drug therapy
  • Memantine / therapeutic use
  • Substance Withdrawal Syndrome / complications*
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / drug therapy

Substances

  • Excitatory Amino Acid Antagonists
  • Hypnotics and Sedatives
  • Lorazepam
  • Memantine