G S Gaind1, P I Rosebush, M F Mazurek. 1. Department of Psychiatry, McMaster University Medical Centre, Hamilton, Ontario, Canada.
Abstract
BACKGROUND: Acute catatonia of the retarded type responds rapidly to treatment with lorazepam. There is little information about (1) the efficacy of benzodiazepines in patients with longstanding catatonic syndrome; (2) the effect of longer-term lorazepam therapy in catatonic patients who do not respond to a brief trial of the medication; and (3) the development of catatonic syndromes in family members. METHOD: We gave lorazepam to two mentally retarded brothers with catatonia. One had become catatonic 2 weeks before starting treatment while the other had been hospitalized in a catatonic state for 5 years. RESULTS: The brother with acute catatonia recovered slowly but completely within 2 weeks of starting lorazepam. The brother with long-standing catatonia responded gradually during the first 5 months of treatment and required higher doses of lorazepam but did eventually recover and was discharged from the hospital on a regimen of lorazepam after 1 year of treatment. CONCLUSION: (1) Lorazepam may be effective even in patients who have been catatonic for years. (2) Catatonic patients who do not recover immediately with lorazepam may respond to a longer course or higher doses of the medication. (3) There may be a familial predisposition to developing catatonia in response to stressful situations.
BACKGROUND: Acute catatonia of the retarded type responds rapidly to treatment with lorazepam. There is little information about (1) the efficacy of benzodiazepines in patients with longstanding catatonic syndrome; (2) the effect of longer-term lorazepam therapy in catatonic patients who do not respond to a brief trial of the medication; and (3) the development of catatonic syndromes in family members. METHOD: We gave lorazepam to two mentally retarded brothers with catatonia. One had become catatonic 2 weeks before starting treatment while the other had been hospitalized in a catatonic state for 5 years. RESULTS: The brother with acute catatonia recovered slowly but completely within 2 weeks of starting lorazepam. The brother with long-standing catatonia responded gradually during the first 5 months of treatment and required higher doses of lorazepam but did eventually recover and was discharged from the hospital on a regimen of lorazepam after 1 year of treatment. CONCLUSION: (1) Lorazepam may be effective even in patients who have been catatonic for years. (2) Catatonic patients who do not recover immediately with lorazepam may respond to a longer course or higher doses of the medication. (3) There may be a familial predisposition to developing catatonia in response to stressful situations.
Authors: Pascal Sienaert; Dirk M Dhossche; Davy Vancampfort; Marc De Hert; Gábor Gazdag Journal: Front Psychiatry Date: 2014-12-09 Impact factor: 4.157