Psychosomatics
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The authors reviewed 23 published cases of psychiatric symptoms in association with baclofen withdrawal. Delirium, and not other functional psychiatric conditions, arose secondarily from abrupt baclofen cessation. ⋯ Complete resolution of delirium symptoms was possible with reinstatement of baclofen. The clinical management of patients experiencing baclofen-withdrawal delirium includes supportive interventions to reduce complications of delirium until symptoms resolve.
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The authors present the case of a 60-year-old woman with elaborate paranoid delusions and cognitive impairment found during a workup for atypical chest pain. Clinical evaluation revealed mild dementia, and radiography showed basal ganglia calcification consistent with Fahr's disease. She was treated with risperidone and transferred to a psychiatric inpatient unit for definitive care. Psychiatrists should consider Fahr's disease as a differential diagnosis in the evaluation of psychosis and cognitive impairment when neuroimaging reveals calcification of the basal ganglia.