Rapid resolution of catatonia secondary to post traumatic stress disorder with secondary psychotic features through scheduled zolpidem tartrate

BMC Psychiatry. 2023 Apr 17;23(1):258. doi: 10.1186/s12888-023-04769-x.

Abstract

Catatonia is a complication of numerous psychiatric and medical conditions. The first-line treatment is typically management of the underlying primary condition as well as scheduled benzodiazepines or electroconvulsive therapy. Electroconvulsive therapy and benzodiazepines are not always tolerated or available when treating patients with catatonia. For this reason, other treatment regimens have been trialed in recent years, including the GABA-modulatory Z drugs such as zolpidem. Some alternative treatment modalities have shown great promise. However, which populaces these are most beneficial for is still unclear. In this article, we examine a case report of a woman who suffered from post-traumatic stress disorder with secondary psychotic features who experienced recurrent akinetic catatonia that was refractory to benzodiazepine therapy. She responded rapidly to scheduled zolpidem with minimal side effects. It is our author's belief that when managing catatonia in patients with post traumatic stress disorder with secondary psychosis, Z drugs may be preferable to benzodiazepines.

Keywords: Benzodiazepines; Catatonia; Post traumatic stress disorder; Post traumatic stress disorder with secondary psychosis; Zolpidem.

Publication types

  • Case Reports

MeSH terms

  • Benzodiazepines / adverse effects
  • Catatonia* / complications
  • Catatonia* / drug therapy
  • Electroconvulsive Therapy*
  • Female
  • Humans
  • Psychotic Disorders* / psychology
  • Stress Disorders, Post-Traumatic* / complications
  • Stress Disorders, Post-Traumatic* / drug therapy
  • Zolpidem / therapeutic use

Substances

  • Zolpidem
  • Benzodiazepines