Bath salts made me catatonic, but the misdiagnosis made my symptoms even worse

A teenager who swallowed bath salts in the Alps was left in a catatonic state, unable to move or speak, for over a month.

The 17-year-old had taken a small tablet while on holiday that police later confirmed was ‘bath salts’, a synthetic stimulant that can cause euphoria and alertness, as well as aggression, violence, paranoia and hallucinations.

She was hallucinating and confused by the drug. When it left her system, the symptoms progressed to severe anxiety and depression.

A week later she went to the hospital anxious, confused and dissociated because she had not slept in days. She had poor balance, slurred speech and difficulty speaking.

Doctors believed the girl had suffered a psychotic attack and began a regimen of antipsychotic medication, which blocks dopamine receptors in the brain.

An excess of dopamine is believed to cause hallucinations, delusions and incoherent thoughts that are characteristic of psychosis.

But her condition worsened and eventually she stopped speaking altogether, a condition called mutism. She did not respond to doctors’ requests or instructions (called negativism), became limp when doctors tried to move her, and refused to eat, requiring a feeding tube.

Although doctors didn’t recognize it at the time, their patient had developed catatonia, a life-threatening mental condition that can lead to blood clots from prolonged lack of exercise, as well as malnutrition, dehydration, muscle wasting and kidney damage.

The teenage patient fell into a catatonic state for about 24 hours after ingesting what police later confirmed were “bath salts,” a synthetic stimulant known to cause change and aggression, as well as symptoms of psychosis (stock photo)

As a result, she developed deep vein thrombosis, a blood clot that forms in a deep vein in the body, usually in the lower leg or thigh. The clot can travel through the bloodstream and make its way to the lungs, blocking blood flow. This can lead to a life-threatening pulmonary embolism.

Bath salts flood the brain with dopamine, the neurotransmitter most associated with pleasure, reward and motivation, as well as motor control.

However, too much dopamine can lead to hallucinations and paranoia, both symptoms of psychosis.

When she first entered the hospital, doctors thought she was in the middle of a psychotic episode as a result of the medications.

She was initially treated with risperidone (an antipsychotic), which was stopped when her condition deteriorated to the point where she required a feeding tube because she could not eat and stopped talking.

When she developed a blood clot as a result of moving very little or not at all for about two weeks in the hospital, doctors took her to the hospital’s medical ward for treatment.

Once there, they reviewed her psychiatric assessment and administered a screening tool for catatonia, the Bush-Francis Catatonia Rating Scale.

She scored high on immobility, mutism, blank stare, unusual posture and negativism, all signs of catatonia.

They removed risperidone from her medication regimen and thought it would be added lorazepam (an anxiety medication) was said to help relieve her symptoms, but it was not fully effective even at a high dose.

They then briefly tried olanzapine (a second antipsychotic), but her condition continued to deteriorate and the symptoms worsened.

She described a feeling of living in a dream, as if you were in the game “The Sims.”

Eventually, as her catatonic symptoms worsened, doctors stopped her on antipsychotics altogether. However, when they kept her on the benzodiazepine, she improved.

Although she had never sought professional treatment for a mental health problem, she had a family history of bipolar disorder, characterized by high-energy manic episodes for a week or more, followed by episodes of depression for at least two weeks.

Doctors started giving her medications that together treat bipolar disorder: lithium and memantine. They followed up with her, although the case report does not say how long after her discharge, and she was still doing well.

According to her medical case reportShe left the hospital after two weeks and made a full recovery a week later.

Catatonia due to drug discontinuation is more commonly seen in people who take medications regularly for months or years and suddenly stop.

But in this patient’s case, her health collapsed after just one drug use, due to a “malignant, unrecognized consequence of newer nasty designer drugs, like ‘bath salts,'” and to genetic predisposition.