Review of adjunctive glutamate antagonist therapy in the treatment of catatonic syndromes

J Neuropsychiatry Clin Neurosci. Fall 2007;19(4):406-12. doi: 10.1176/jnp.2007.19.4.406.

Abstract

Catatonia is a common neuropsychiatric syndrome which may arise from GABA-A hypoactivity, dopamine (D2) hypoactivity,and possibly glutamate NMDA hyperactivity. Amantadine and memantine have been reported as effective treatments for catatonia in selected cases, and probably mediate the presence of catatonic signs and symptoms through complex pathways involving glutamate antagonism. The authors identified 25 cases of catatonia treated with either agent. This article provides indirect evidence that glutamate antagonists may improve catatonic signs in some patients who fail to respond to established treatment, including lorazepam or electroconvulsive therapy. Further study of glutamate antagonists in the treatment of catatonia is needed.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Catatonia / drug therapy*
  • Catatonia / psychology
  • Clinical Trials as Topic
  • Electroconvulsive Therapy
  • Excitatory Amino Acid Antagonists* / therapeutic use*
  • GABA Modulators / therapeutic use
  • Humans
  • Lorazepam / therapeutic use
  • Psychiatric Status Rating Scales
  • Schizophrenia, Catatonic / drug therapy
  • Schizophrenia, Catatonic / psychology

Substances

  • Excitatory Amino Acid Antagonists
  • GABA Modulators
  • Lorazepam