Effective Treatment of Catatonia by Combination of Benzodiazepine and Electroconvulsive Therapy

Ünal, Ahmet; Bülbül, Feridun; Alpak, Gökay; Virit, Osman; Çöpoğlu, Ümit Sertan; Savaş, Haluk A.

doi:10.1097/yct.0b013e3182887a1a

Cited by 35 publications

(20 citation statements)

References 17 publications

(27 reference statements)

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“… 10 , 11 In addition, dysfunction of gamma-aminobutyric acid and glutamate systems may be implicated. 12 Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of catatonia treatment

Pelzer¹,

Heijden²,

Boer³

2018

NDT

114

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ObjectiveTo investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol.Materials and methodsA systematic review of published treatment articles (case series, cohort or randomized controlled studies) which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO.ResultsThirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT) proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%–100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder.ConclusionLorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted.

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Section: Introductionmentioning

confidence: 99%

Systematic review of catatonia treatment

Pelzer¹,

Heijden²,

Boer³

2018

NDT

114

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“…Even if the efficacy of ECT in catatonia is widely acknowledged, only small open and retrospective studies are available in the field. Moreover, most of these observations were conducted in heterogeneous samples of patients diagnosed with varying frequencies as having schizophrenia (20%–100%) or mood disorders (0%–63%), not always on the  basis of valid criteria [89-95]. In these studies, ECT resulted very effective with responses ranging from 80 to 90%; only one report showed response rate of 59% [96].…”

Section: Introductionmentioning

confidence: 99%

The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features

Perugi

Medda

Toni³

et al. 2017

124

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Objective:We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features.Method:522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features.Results:Of the original sample only 22 patients were excluded for the occurrence of side effects or consent withdrawal. After the ECT course, 344 (68.8%) patients were considered responders (final CGIi score ≤2) and 156 (31.2%) nonresponders. Response rates were respectively 68.1% for BD depression, 72.9% for mixed state, 75% for mania and 80.8% for catatonic features. Length of current episode and global severity of the illness were the only statistically significant predictors of nonresponse.Conclusion:ECT resulted to be an effective and safe treatment for all the phases of severe and drug-resistant BD. Positive response was observed in approximately two-thirds of the cases and in 80% of the catatonic patients. The duration of the current episode was the major predictor of nonresponse. The risk of ECT-induced mania is virtually absent and mood destabilization very unlikely. Our results clearly indicate that current algorithms for the treatment of depressive, mixed, manic and catatonic states should be modified and, at least for the most severe patients, ECT should not be considered as a “last resort”.

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“…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 . ECT has been shown to be effective with rates of response ranging from 53% to 100% .…”

mentioning

confidence: 99%

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

Medda

Toni²,

Luchini

et al. 2015

Bipolar Disorders

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Effective Treatment of Catatonia by Combination of Benzodiazepine and Electroconvulsive Therapy

Abstract: In our study, full recovery was achieved in catatonia by benzodiazepine plus ECT combination. As a result, we recommend combined ECT and benzodiazepine for catatonia.

Cited by 35 publications

References 17 publications

Systematic review of catatonia treatment

Systematic review of catatonia treatment

The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features

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

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