Abstract
In a prospective open trial, 30 inpatients with catatonic signs were treated systematically with oral lorazepam (dosage ranging between 3 to 8 mg/d) for a period of 5 days and subsequently with ECT if lorazepam trial failed. Outcome was monitored quantitatively during the treatment phase with Bush-Francis catatonia rating scale. In 21 out of 30 patients (70%), catatonic signs resolved with lorazepam trial. The response to lorazepam on Day 1, predicted the final outcome. Demographic variables, severity of catatonia or length of catatonic syndrome prior to treatment did not have any predictive value. Majority of the patients who showed an unfavourable response, did well with electroconvulsive therapy. A short duration lorazepam administration proved to be a safe and effective treatment for the catatonic syndrome.
Keywords: Catatonia, lorazepam, electroconvulsive therapy
Full Text
The Full Text of this article is available as a PDF (192.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abrams R., Taylor M. A. Catatonia. A prospective clinical study. Arch Gen Psychiatry. 1976 May;33(5):579–581. doi: 10.1001/archpsyc.1976.01770050043006. [DOI] [PubMed] [Google Scholar]
- Benegal V., Hingorani S., Khanna S., Channabasavanna S. M. Is stupor by itself a catatonic symptom? Psychopathology. 1992;25(5):229–231. doi: 10.1159/000284777. [DOI] [PubMed] [Google Scholar]
- Benegal V., Hingorani S., Khanna S. Idiopathic catatonia: validity of the concept. Psychopathology. 1993;26(1):41–46. doi: 10.1159/000284798. [DOI] [PubMed] [Google Scholar]
- Bush G., Fink M., Petrides G., Dowling F., Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996 Feb;93(2):129–136. doi: 10.1111/j.1600-0447.1996.tb09814.x. [DOI] [PubMed] [Google Scholar]
- Bush G., Fink M., Petrides G., Dowling F., Francis A. Catatonia. II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand. 1996 Feb;93(2):137–143. doi: 10.1111/j.1600-0447.1996.tb09815.x. [DOI] [PubMed] [Google Scholar]
- Fricchione G. L., Cassem N. H., Hooberman D., Hobson D. Intravenous lorazepam in neuroleptic-induced catatonia. J Clin Psychopharmacol. 1983 Dec;3(6):338–342. [PubMed] [Google Scholar]
- McCall W. V., Shelp F. E., McDonald W. M. Controlled investigation of the amobarbital interview for catatonic mutism. Am J Psychiatry. 1992 Feb;149(2):202–206. doi: 10.1176/ajp.149.2.202. [DOI] [PubMed] [Google Scholar]
- Menza M. A., Harris D. Benzodiazepines and catatonia: an overview. Biol Psychiatry. 1989 Dec;26(8):842–846. doi: 10.1016/0006-3223(89)90124-8. [DOI] [PubMed] [Google Scholar]
- Salam S. A., Kilzieh N. Lorazepam treatment of psychogenic catatonia: an update. J Clin Psychiatry. 1988 Dec;49 (Suppl):16–21. [PubMed] [Google Scholar]
- Sartorius N., Jablensky A., Korten A., Ernberg G., Anker M., Cooper J. E., Day R. Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders. Psychol Med. 1986 Nov;16(4):909–928. doi: 10.1017/s0033291700011910. [DOI] [PubMed] [Google Scholar]
- Ungvari G. S., Leung C. M., Wong M. K., Lau J. Benzodiazepines in the treatment of catatonic syndrome. Acta Psychiatr Scand. 1994 Apr;89(4):285–288. doi: 10.1111/j.1600-0447.1994.tb01515.x. [DOI] [PubMed] [Google Scholar]
- Vinogradov S., Reiss A. L. Use of lorazepam in treatment-resistant catatonia. J Clin Psychopharmacol. 1986 Oct;6(5):323–325. [PubMed] [Google Scholar]
- Wetzel H., Benkert O. Lorazepam for treatment of catatonic symptoms and severe psychomotor retardation. Am J Psychiatry. 1988 Sep;145(9):1175–1176. doi: 10.1176/ajp.145.9.1175b. [DOI] [PubMed] [Google Scholar]
- Wetzel H., Heuser I., Benkert O. Stupor and affective state: alleviation of psychomotor disturbances by lorazepam and recurrence of symptoms after Ro 15-1788. J Nerv Ment Dis. 1987 Apr;175(4):240–242. doi: 10.1097/00005053-198704000-00010. [DOI] [PubMed] [Google Scholar]