Lorazepam and Diazepam Rapidly Relieve Catatonic Features in Major Depression

Abstract

We have proved that a modified strategy (ie, lorazepam intramuscular injection [IMI] or diazepam intravenous drip [IVD] if lorazepam IMI fails) can rapidly relieve catatonic features in patients with schizophrenia. During a period of 3 years, we identified 7 major depressive patients with catatonic features in the emergency unit of a general hospital. The patients were treated with lorazepam IMI (dose, 2 mg/mL.per ampule) once or twice during the first 2 hours. If lorazepam IMI failed, diazepam IVD (dose, 10 mg/2 mL.per ampule) in 500 mL normal saline every 8 hours for 1 day would be administered. The total complete remission rate to lorazepam IMI within 2 hours was 6 (85.7%) per 7 patients, and the total complete remission rate to benzodiazepines (lorazepam IMI and diazepam IVD) within 1 day was 7 (100%) of all 7 patients. These results highly suggest that this modified strategy can also rapidly relieve catatonic features in major depression within 1 day and attain a high complete remission rate, even without electroconvulsive therapy.

An intercalation mechanism as a mode of action exerted by psychotropic drugs: results of altered phospholipid substrate availabilities in membranes?

“…No clinical evidence exists today, however, to confirm these claims. In contrary DZP still has clear Adapted from Anja Underhaug-Gjerde indications for use in clinical psychiatry, especially in the catatonic phases of schizophrenia [71,80] and depression [83] besides its applications as an adjuvant to other antipsychotic drugs or alone [11,29,104,138] to treat psychosis. The decreasing ranking order of the drugs in PLA 2 inhibition was as follows: [131,132] (see also Table 1).…”

Rapid Relief of Catatonia in Mood Disorder by Lorazepam and Diazepam

“…The response rate with lorazepam was slightly lower than that in our previous research on MDD (lorazepam response rate 85.7% and 1-day response rate 100%). [25] The risk factors for catatonia in depression are increasing age, higher frequency of major depressive episodes, more severe impairment in cognitive function and daily activity. [26] In this study, we had no data of non-catatonia patients in MDD to investigate the age distribution between catatonia and non-catatonia groups.…”

“…In this study, we excluded patients who were reported previously. [25] After making the diagnosis of catatonia, the following lorazepam-diazepam treatment strategy was performed to treat catatonia: (A) IMI, 1 ampule (2 mg/mL per ampule); (B) if the patient failed to respond to the first dose of lorazepam IMI, repeat one dose of lorazepam IMI, 1 ampule, within 2 h; (C) if the above two doses of lorazepam IMI were ineffective, diazepam IVD every 8 h was prescribed (10 mg/2 mL per ampule, infused in 500 mL per bottle concentration of normal saline); (D) until the remission of catatonia, all patients were drug-free except the above lorazepam or diazepam use. The epidemiologic data and the treatment response toward lorazepam-diazepam treatment strategy of the patients were analyzed and discussed.…”

“…Huang used a lorazepam-diazepam treatment strategy to relieve catatonia rapidly in patients with schizophrenia and major depressive disorder (MDD). [24,25] In this study, we collected more patient data since our last report to investigate the efficacy of this treatment strategy in catatonic patients with MDD and bipolar I disorder (BPI).…”

Catatonia in Affective Disorders

“…In the emergency department of a Taiwanese general hospital Huang et al [29] diagnosed 7 patients (5 women) with major depressive episode with catatonic symptoms between 2002 and 2005. The same research team examined 15 women suffering in post-partum psychiatric disorder.…”