Cholinergic rebound syndrome: Why we should NOT stop anticholinergic medications abruptly

From a Member: As we are coming down on clozapine, with each step [my patient] has a rapid heartbeat, some activation, some nausea, some headache. I think it is possibly anticholinergic withdrawal. When I was early in the first year of my psychiatry residency, I had a patient whose medications included haloperidol and a full…