Catatonia with schizophrenia: From ECT to rTMS

Stip, Emmanuel; Blain-Juste, M.-E.; Farmer, Olivier; Fournier‐Gosselin, Marie‐Pierre; Lespérance, Paul

doi:10.1016/j.encep.2017.09.008

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…18 Studies have suggested the use of repetitive transcranial magnetic stimulation (rTMS) as an alternative to ECT for the treatment of persistent severe catatonia for both acute treatment and maintenance. 19…”

Section: Discussionmentioning

confidence: 99%

Catatonia in major depressive disorder: diagnostic dilemma. A case report

Ojimba¹,

Isidahome²,

Odenigbo³

et al. 2019

JPCPY

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Catatonia is a complex neuropsychiatric syndrome that is often associated with psychiatric, neurological and/or medical conditions. In order to make a diagnosis of catatonia, the clinical picture must be dominated by three or more of the following symptoms; cataplexy, waxy flexibility, stupor, agitation, mutism, negativism, posturing, mannerisms, stereotypies, grimacing, echolalia, and echopraxia. We present a case of a 58-year-old female with no prior psychiatric history who presented to the psychiatric emergency room with a threeweek history of feeling depressed, anhedonic, hopeless, helpless, and worthless, associated with poor sleep, poor concentration, low energy, significant weight loss due to lack of appetite, and suicidal ideations after she saw her ex-boyfriend holding hands with another woman. Patient exhibited symptoms such as mutism, hyperextension of spine, clinching of jaw, psychomotor retardation which suggested probable diagnosis of catatonia at the background of major depressive disorder nonresponding to treatment. This case report demonstrates the need for a high index of suspicion and early screening for catatonia in psychiatric patients given the high morbidity and mortality that is associated with this condition if delayed or undiagnosed.

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Section: Discussionmentioning

confidence: 99%

Catatonia in major depressive disorder: diagnostic dilemma. A case report

Ojimba¹,

Isidahome²,

Odenigbo³

et al. 2019

JPCPY

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“…Contraindications to ECT include myocardial infarction within 3 months, elevated intracranial pressure, pheochromocytoma, cerebral tumors, and cerebral aneurysms [ 60 ]. Associated side effects may include impaired new learning, anterograde and retrograde amnesia, and autobiographical memory; these side effects usually resolve within weeks to months, but it may take up to 6 months for cognitive function to return to baseline [ 61 , 62 , 63 ]. A previous history of cognitive impairment places patients at higher risk of developing side effects [ 61 ].…”

Section: Catatonia Current Treatmentmentioning

confidence: 99%

Catatonia: Clinical Overview of the Diagnosis, Treatment, and Clinical Challenges

Edinoff

Kaufman

Hollier

et al. 2021

Neurology International

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Catatonia is a syndrome that has been associated with several mental illness disorders but that has also presented as a result of other medical conditions. Schizophrenia and other psychiatric disorders such as mania and depression are known to be associated with catatonia; however, several case reports have been published of certain medical conditions inducing catatonia, including hyponatremia, cerebral venous sinus thrombosis, and liver transplantation. Neuroleptic Malignant Syndrome and anti-NMDA receptor encephalitis are also prominent causes of catatonia. Patients taking benzodiazepines or clozapine are also at risk of developing catatonia following the withdrawal of these medications—it is speculated that the prolonged use of these medications increases gamma-aminobutyric acid (GABA) activity and that discontinuation may increase excitatory neurotransmission, leading to catatonia. The treatment of catatonia often involves the use of benzodiazepines, such as lorazepam, that can be used in combination therapy with antipsychotics. Definitive treatment may be found with electroconvulsive therapy (ECT). Aberrant neuronal activity in different motor pathways, defective neurotransmitter regulation, and impaired oligodendrocyte function have all been proposed as the pathophysiology behind catatonia. There are many clinical challenges that come with catatonia and, as early treatment is associated with better outcomes, it becomes imperative to understand these challenges. The purpose of this manuscript is to provide an overview of these challenges and to look at clinical studies regarding the pathophysiology, diagnosis, and treatment of as well as the complications and risk factors associated with catatonia.

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“…Budući da je konzilijarno zaključeno da se zbog tromboembolije pluća, EKT smatra procedurom visokog rizika u narednih 6 meseci, EKT se smatra kontraindikovanim [18]. Somatska terapija bi bila propisana u skladu sa internističkim preporukama.…”

Section: Diskusijaunclassified

The syndrome of catatonia

Milinović¹,

Todorović²

2020

Halo 194

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Katatoni sindrom predstavlja oštećenje voljne aktivnosti, javlja se u sklopu poremećaja raspoloženja, katatone shizofrenije, konverzivnih poremećaja, neuroloških bolesti, metaboličkih poremećaja, toksičnih infekcija centralnog nervnog sistema, virusnih infekcija i autoimunih bolesti. Cilj rada je prikaz pacijentkinje kod koje je razmatrana dijagnoza disocijativnog stupora iz nekoliko razloga. Prvo, zbog postojanja vremenske povezanosti između početka simptoma poremećaja i stresogenih događaja. Drugo, zbog dubokog smanjenja voljnih pokreta, govora i normalnog reagovanja na svetlost, buku i dodir, uz održan normalan tonus mišića, telesni stav i disanje. Na kraju, ključni razvojni zadatak, prelazak pacijentkinje iz faze simbioze (stopljenosti) s majkom i zavisnosti od nje, u stanje povećane nezavisnosti i diferencijacije, koji nije razrešen. U dijagnostici i lečenju se primenjuje integrativni pristup prema redu hitnosti i težini kliničke slike, a nakon produženog stacionarnog lečenja indikovano je nastaviti sa medikamentoznom terapijom i psihoterapijskom podrškom.

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Catatonia with schizophrenia: From ECT to rTMS

Abstract: rTMS is helpful for acute and maintenance treatment for catatonic schizophrenia who both failed multiple pharmacologic interventions and had safety concerns with continuing maintenance ECT. Clinicians should consider rTMS as a potential treatment option for refractory catatonia.

Cited by 18 publications

References 19 publications

Catatonia in major depressive disorder: diagnostic dilemma. A case report

Catatonia in major depressive disorder: diagnostic dilemma. A case report

Catatonia: Clinical Overview of the Diagnosis, Treatment, and Clinical Challenges

The syndrome of catatonia

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