Catatonia in Psychotic Patients: Clinical Features and Treatment Response

Abstract

We report clinical features and treatment response in 25 patients with catatonia admitted to an inpatient psychiatric unit specializing in psychotic disorders. ECT, benzodiazepines, and clozapine had beneficial effects on catatonic features, while typical antipsychotics resulted in clinical worsening.

Catatonia in 26 patients with bipolar disorder: clinical features and response to electroconvulsive therapy

“…Almost every patient displayed the combination of stupor, staring, negativism, withdrawal, and mutism. These observations are in line with those of other authors (15,20,39). In contrast, rigidity was present in all of the patients and was much more frequently represented than in other samples.…”

“…The remarkable efficacy of ECT in catatonic patients is generally acknowledged, but it is based on small open case series and retrospective studies. Furthermore, most of these studies were carried out in heterogeneous samples of patients diagnosed with varying frequencies as having schizophrenia (20%-100%) or mood disorders (0%-63%), depending on the studied population and the diagnostic preferences of the investigators (15)(16)(17)(18)(19)(20)(21)(22). ECT has been shown to be effective with rates of response ranging from 53% to 100% (12).…”

Neuromyelitis optica presenting with psychiatric symptoms and catatonia: a case report

“…There is less clarity on the role played by antipsychotic medications in patients with catatonia and especially in treating patients presenting with both psychosis and catatonia [8]. While most patients have a robust response to lorazepam, some cannot tolerate higher doses or the effects are not sustained [8].…”

ECT in schizophrenia: a review of the evidence

“…Effectiveness of ECT in schizophrenia has also been evaluated in several subgroups of patients with schizophrenia like (1) patients with specific subtype of schizophrenia, (2) patients with first episode schizophrenia (FES) and (3) adolescents. Studies which have evaluated the effectiveness of ECT in catatonic schizophrenia have been inconclusive, with some suggesting no significant beneficial effects of ECT in patients with chronic catatonic schizophrenia (26,27). One recent double-blind randomised study, randomised 14 patients with non-affective (schizophrenia and psychosis NOS) catatonia of varying duration of illness, non-responsive to lorazepam to 2 groups (ECT plus placebo vs. risperidone plus ‘sham’ ECT) (28).…”