Electroconvulsive Therapy for Catatonia

Waarde, Jeroen A. van; Tuerlings, J.H.A.M.; Verwey, Bastiaan; Mast, Rose C. van der

doi:10.1097/yct.0b013e3181c18a13

Cited by 48 publications

(19 citation statements)

References 10 publications

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“… 16 , 30 , 32 , 34 – 36 ECT was not only initiated after ineffective pharmacotherapy, but also as primary therapy, for example, in life-threatening situations. 18 , 25 , 37 – 39 The reported bilateral ECT frequency was three times a week on average. 25 , 30 , 35 , 36 , 38 , 39 In two studies, ECT was administered unilaterally, the hypothesis being that this would reduce the risk of cognitive side effects.…”

Section: Resultsmentioning

confidence: 99%

“…The percentages, represented in terms of response and remission ( Table 2 ), ranged from 59% to 100%. 16 , 37 Most articles were based on chart reviews and case studies and, consequently, lacked any form of randomization, control group, uniform treatment and crucial information on medication or co-medication. Of the 11 studies which investiged ECT, six studies actively reported about side effects.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of catatonia treatment

Pelzer¹,

Heijden²,

Boer³

2018

NDT

115

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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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Systematic review of catatonia treatment

Pelzer¹,

Heijden²,

Boer³

2018

NDT

115

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“…Echophenomena predicted a slower response ( 136 ). The lowest response rates were reported in a retrospective study of 27 patients, treated with bitemporal ECT, often daily during the first week ( 47 ). Response rates were 59%.…”

Section: Treatment Of Catatoniamentioning

confidence: 96%

“…Fink states that prognosis is especially favorable when the syndrome is dominated by stupor, hyperactivity, rapid, and pressured speech, and lability of mood, or if there is a previous episode with recovery, a rapid onset of the episode, and good social functioning prior to the episode ( 45 , 46 ). Van Waarde and co-workers have examined predictors of response to ECT in 27 catatonic patients and found improvement to be significantly associated with younger age, and the presence of autonomic dysregulation, especially higher body temperature ( 47 ). There is anecdotal evidence that organic catatonia is less responsive, or does not respond at all, to ECT.…”

Section: Prognosismentioning

confidence: 99%

A Clinical Review of the Treatment of Catatonia

Sienaert¹,

Dhossche²,

Vancampfort³

et al. 2014

Front. Psychiatry

235

312

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Catatonia is a severe motor syndrome with an estimated prevalence among psychiatric inpatients of about 10%. At times, it is life-threatening especially in its malignant form when complicated by fever and autonomic disturbances. Catatonia can accompany many different psychiatric illnesses and somatic diseases. In order to recognize the catatonic syndrome, apart from thorough and repeated observation, a clinical examination is needed. A screening instrument, such as the Bush-Francis Catatonia Rating Scale, can guide the clinician through the neuropsychiatric examination. Although severe and life-threatening, catatonia has a good prognosis. Research on the treatment of catatonia is scarce, but there is overwhelming clinical evidence of the efficacy of benzodiazepines, such as lorazepam, and electroconvulsive therapy.

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“…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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Electroconvulsive Therapy for Catatonia

Abstract: Most of our patients with catatonia benefited from ECT, especially younger patients with autonomic dysregulation. Daily administration of ECT may be more effective, whereas longer duration of seizure activity at the final ECT session was related to better response to ECT.

Cited by 48 publications

References 10 publications

Systematic review of catatonia treatment

Systematic review of catatonia treatment

A Clinical Review of the Treatment of Catatonia

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

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