Cocaine and Catatonia
Her mother brought Ms. A, a 36-year-old woman with no prior psychiatric history except cocaine abuse, to the emergency ward after 6 days of bizarre and withdrawn behavior following a crack-cocaine binge. In the emergency ward, Ms. A continued to exhibit mutism, staring, active resistance to being touched or moved, and purposeless, stereotyped hand gestures. Haloperidol (1 mg i.m.), administered for presumed cocaine-induced psychosis, had no effect. A psychiatric consultant diagnosed catatonia and administered lorazepam (2 mg i.m.). Two hours later, Ms. A was alert, oriented, cooperative, and responsive to questions and commands. Her vital signs and results of laboratory tests and physical examination were unremarkable except for cocaine in her urine.
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