A Case of Schizophrenia With Catatonia Resistant to Lorazepam and Olanzapine Monotherapy But Responsive to Combination Treatment: Is It Time to Consider Using Select Second-Generation Antipsychotics Earlier in the Treatment Algorithm for This Patient Type?

Clin Neuropharmacol. Mar/Apr 2019;42(2):57-59. doi: 10.1097/WNF.0000000000000327.

Abstract

Objective: Catatonia is a distinct psychomotor syndrome that involves a constellation of up to 40 different symptoms. Although conventionally responsive to benzodiazepines, the catatonic syndrome is much more resistant to benzodiazepine treatment when a feature of schizophrenia.

Method: We present a patient with schizophrenia with catatonic symptoms, marginally responsive to lorazepam challenge, lorazepam, and olanzapine monotherapy, but ultimately began combination treatment with these 2 medications.

Results: Our patient's score on the Bush-Francis Catatonia Rating Scale significantly decreased after 2 weeks of combination lorazepam and olanzapine without adverse effects.

Conclusion: We propose a modification to the standard treatment protocol for catatonia, especially in those patients with schizophrenia with catatonic features.

Publication types

  • Case Reports

MeSH terms

  • Algorithms*
  • Antipsychotic Agents / administration & dosage*
  • Catatonia / complications
  • Catatonia / diagnosis
  • Catatonia / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lorazepam / administration & dosage*
  • Middle Aged
  • Olanzapine / administration & dosage*
  • Schizophrenia / complications
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Olanzapine
  • Lorazepam