A case of delirium, motor disturbances, and autonomic dysfunction due to baclofen and tizanidine withdrawal: a review of the literature

Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):84.e1-2. doi: 10.1016/j.genhosppsych.2010.10.003. Epub 2010 Nov 13.

Abstract

We report a case of delirium accompanied by extrapyramidal symptoms and autonomic dysfunction in a 59-year-old man following abrupt cessation of baclofen and tizanidine. An extensive search for the etiology was undertaken, but it was only after a careful history was taken that suspicion for baclofen and tizanidine withdrawal was raised. The delirium and motor disturbances resolved within 24 h of reintroduction of baclofen. Withdrawal from muscle relaxants requires a high index of suspicion but should be considered in patients who manifest signs and symptoms of withdrawal from the medications, particularly visual hallucinations, rigidity and autonomic dysfunction.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Akathisia, Drug-Induced / etiology*
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Autonomic Nervous System Diseases / chemically induced*
  • Baclofen / administration & dosage
  • Baclofen / adverse effects*
  • Clonidine / administration & dosage
  • Clonidine / adverse effects
  • Clonidine / analogs & derivatives*
  • Delirium / chemically induced*
  • Humans
  • Male
  • Middle Aged
  • Substance Withdrawal Syndrome / etiology

Substances

  • Anticonvulsants
  • tizanidine
  • Baclofen
  • Clonidine