Table 3.

Intensive care symptom-guided therapies.

Symptoms	First-line therapy	Second-line therapy	Refractory therapy
Agitation	Trihexyphenidyl (0.02–0.06 mg/kg or 1 mg 1–2 times daily) and low-dose opioids (fentanyl 1 μg/kg/h infusion or bolus)	Dexmedetomidine infusion (0.2 μg–1.5 μg/kg/min)	Propofol infusion (10–30 μg/kg/min)
Catatonia autonomic dysfunction bradycardia	Glycopyrrolate (0.004–0.01 mg/kg q4–8 h prn: maximum, 0.1–0.2 mg/dose, 0.8 mg/day)	Theophylline (begin oral 300 mg/day divided q4–6 h up to a maximum dose 600 mg/24 h)	Electroconvulsive therapy
Hypoventilation			Tracheostomy (if ventilated for >4 weeks)
Additional considerations			Gastric-tube placement
			Early physical therapy