Persistent mutism and secondary obsessive-compulsive disorder due to clozapine in a patient with schizophrenia and catatonia: a case report
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1251Keywords:
schizophrenia, treatment-resistant, mutism, obsessive-compulsive disorder, clozapine, OCDAbstract
Introduction: Catatonia is a syndrome often associated with other psychiatric conditions, such as schizophrenia. This condition is characterized by various psychomotor dysfunctions, including mutism. Objective: To describe a case of a patient with schizophrenia and chronic catatonic mutism for 18 years, resistant to clozapine and with secondary obsessive-compulsive disorder due to the antipsychotic. Method: Case report. CAEE number 82175524.3.0000.5192, Hospital Complex HUOC PROCAPE. Free and informed consent form signed. Case presentation: A 36-year-old man has a history of recurrent catatonia associated with schizophrenia since 2006, characterized mainly by chronic mutism, communicating only in writing. Ongoing interventions by the mother diagnosed with Munchausen syndrome by proxy contributed to the complexity of the case. After starting pharmacological treatment with clozapine, which did not yield adequate therapeutic results, he developed obsessive-compulsive symptoms. Discussion: The patient's history highlights the complexity in the clinical and pharmacological management of schizophrenia linked to persistent catatonic mutism. Despite the use of various antipsychotics, the medication therapeutic response proved insufficient, suggesting treatment refractoriness, and triggering the development of secondary obsessive-compulsive disorder (OCD) to clozapine, emphasizing the challenges faced in handling the case. Conclusion: Emphasizes the need for therapeutic approaches adapted to the individual complexities of patients with catatonia and schizophrenia, as well as the importance of continuous research to develop more effective treatment strategies.
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Copyright (c) 2024 Matheus Alheiros Cassundé, João Cortez de Oliveira, Leticia Araujo Sampaio Mendes, Maria Carolina Stamford Borges, Murilo Medeiros Menegusse, Antonio Medeiros Peregrino da Silva
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