Undiagnosed Triazolam Withdrawal

Abstract

Objective:

To report a case of triazolam withdrawal.

Case Summary:

A 65-year-old white man was admitted to the hospital for a total left hip arthroplasty. Within 12 hours after the surgery, the patient became agitated and confused, and reported severe chest pain. He was treated for a non-Q-wave myocardial infarction, but continued to experience fluctuating consciousness, confusion, agitation, auditory and visual hallucinations, and memory deficits, which did not respond to treatment with haloperidol and discontinuation of meperidine, which was administered after the surgery. He responded briefly to midazolam. A detailed history of the patient's preoperative medications was obtained from his wife. This led to the diagnosis of triazolam withdrawal, and the patient was successfully treated.

Discussion:

The covert use and misuse of medications is a common cause of psychosis in otherwise healthy individuals. This case emphasizes how obtaining a detailed medication history from the patient or other sources can prevent serious complications.

Conclusions:

Benzodiazepine withdrawal can present with psychiatric symptoms. This case highlights the importance of obtaining information from patients and family on the use of medications that can cause acute withdrawal reactions.