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Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal

We report two serious and unusual complications of benzodiazepine withdrawal in a single patient: takotsubo cardiomyopathy and catatonia. This 61-year-old female patient was brought to the emergency department with lethargy and within hours had declined into a state of catatonia. Although there was...

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Autores principales: Peng, Teng J., Patchett, Nicholas D., Bernard, Sheilah A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980508/
https://www.ncbi.nlm.nih.gov/pubmed/27547472
http://dx.doi.org/10.1155/2016/8153487
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author Peng, Teng J.
Patchett, Nicholas D.
Bernard, Sheilah A.
author_facet Peng, Teng J.
Patchett, Nicholas D.
Bernard, Sheilah A.
author_sort Peng, Teng J.
collection PubMed
description We report two serious and unusual complications of benzodiazepine withdrawal in a single patient: takotsubo cardiomyopathy and catatonia. This 61-year-old female patient was brought to the emergency department with lethargy and within hours had declined into a state of catatonia. Although there was never a complaint of chest pain, ECG showed deep anterior T-wave inversions and cardiac enzymes were elevated. An echocardiogram was consistent with takotsubo cardiomyopathy. She later received 1 mg of midazolam and within minutes had resolution of catatonic symptoms. Careful history revealed that she had omitted her daily dose of lorazepam for 3 days prior to admission. To our knowledge, the case presented herein is the first report of simultaneous catatonia and takotsubo cardiomyopathy in the setting of benzodiazepine withdrawal. The pathogenesis of both conditions is poorly understood but may be indirectly related to the sudden decrease in γ-aminobutyric acid (GABA) signaling during benzodiazepine withdrawal.
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spelling pubmed-49805082016-08-21 Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal Peng, Teng J. Patchett, Nicholas D. Bernard, Sheilah A. Case Rep Cardiol Case Report We report two serious and unusual complications of benzodiazepine withdrawal in a single patient: takotsubo cardiomyopathy and catatonia. This 61-year-old female patient was brought to the emergency department with lethargy and within hours had declined into a state of catatonia. Although there was never a complaint of chest pain, ECG showed deep anterior T-wave inversions and cardiac enzymes were elevated. An echocardiogram was consistent with takotsubo cardiomyopathy. She later received 1 mg of midazolam and within minutes had resolution of catatonic symptoms. Careful history revealed that she had omitted her daily dose of lorazepam for 3 days prior to admission. To our knowledge, the case presented herein is the first report of simultaneous catatonia and takotsubo cardiomyopathy in the setting of benzodiazepine withdrawal. The pathogenesis of both conditions is poorly understood but may be indirectly related to the sudden decrease in γ-aminobutyric acid (GABA) signaling during benzodiazepine withdrawal. Hindawi Publishing Corporation 2016 2016-07-28 /pmc/articles/PMC4980508/ /pubmed/27547472 http://dx.doi.org/10.1155/2016/8153487 Text en Copyright © 2016 Teng J. Peng et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Peng, Teng J.
Patchett, Nicholas D.
Bernard, Sheilah A.
Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title_full Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title_fullStr Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title_full_unstemmed Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title_short Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal
title_sort takotsubo cardiomyopathy and catatonia in the setting of benzodiazepine withdrawal
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980508/
https://www.ncbi.nlm.nih.gov/pubmed/27547472
http://dx.doi.org/10.1155/2016/8153487
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