The Use of Lorazepam and Electroconvulsive Therapy in the Treatment of Catatonia: Treatment Characteristics and Outcomes in 60 Patients

J ECT. 2017 Dec;33(4):290-293. doi: 10.1097/YCT.0000000000000433.

Abstract

Objectives: Lorazepam and electroconvulsive therapy (ECT) are effective treatments for catatonia. However, systematic data on these treatments in catatonia are limited. In the present study, we aimed to investigate the clinical and treatment-related characteristics of patients with catatonia who underwent lorazepam and/or ECT.

Methods: Between January 2012 and December 2016, we received 60 patients with catatonia hospitalized in the Gaziantep University Faculty of Medicine Clinic of Psychiatry. Lorazepam and/or ECT were used in the patients' treatment schedule. Treatment results were evaluated using the Bush-Francis Catatonia Rating Scale and Clinical Global Impression-Improvement.

Results: Thirty-five patients (58.3%) in the sample were in their first catatonic episode. The most common comorbidity was mood disorder (n = 34, 56.7%), whereas the most frequent catatonic sign was mutism (n = 43, 71.7%). Moreover, 31 patients (51.7%) had some form of medical comorbidity. Cerebral abnormalities were detected in computed tomography/magnetic resonance imaging in 22 patients (36.7%). Furthermore, 95% of the patients (n = 57) fully recovered after administration of the treatment.

Conclusions: Lorazepam is a reasonable initial choice in the treatment of catatonia, with rapid consideration for ECT if there is no rapid response to lorazepam.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Catatonia / drug therapy
  • Catatonia / therapy*
  • Combined Modality Therapy
  • Electroconvulsive Therapy / methods*
  • Female
  • GABA Modulators / therapeutic use*
  • Humans
  • Lorazepam / therapeutic use*
  • Male
  • Middle Aged
  • Mood Disorders / complications
  • Mood Disorders / psychology
  • Mood Disorders / therapy
  • Mutism / etiology
  • Mutism / psychology
  • Mutism / therapy
  • Psychiatric Status Rating Scales
  • Treatment Outcome
  • Young Adult

Substances

  • GABA Modulators
  • Lorazepam