Methamphetamine-associated catatonia: Case series and systematic review of the literature from 1943-2020

Ann Clin Psychiatry. 2023 Aug;35(3):167-177. doi: 10.12788/acp.0116.

Abstract

Background: Catatonia due to a general medical condition may result from a variety of causes, including substance intoxication and withdrawal. Stimulants are occasionally associated with catatonia, though there has been little investigation of methamphetamine's relationship to catatonia. Here we present 5 cases of catatonia associated with methamphetamine use and a systematic review of the associated literature from 1943 to 2020.

Methods: We performed a systematic review of the literature and present 5 cases of catatonia evaluated using the Bush-Francis Catatonia Rating Scale and KANNER catatonia rating scale.

Results: Methamphetamine use was associated with catatonia in a small number of cases in the literature. However, some of these reports included other possible etiologies. The patients in our case series met DSM-5 criteria for catatonia due to a general medical condition, with all reporting recent methamphetamine use and testing positive for amphetamines on urine drug screen.

Conclusions: Given the ongoing rise in methamphetamine use in the United States, it is important that clinicians understand that methamphetamine use can be associated with catatonia. Patients with methamphetamine-associated catatonia may respond favorably to lorazepam and require shorter hospital stays than other catatonic patients. Lastly, methamphetamine-associated catatonia highlights how alteration in dopamine function and projections may be a critical neural mechanism underlying catatonia in general.

Publication types

  • Systematic Review

MeSH terms

  • Catatonia* / chemically induced
  • Central Nervous System Stimulants* / adverse effects
  • Humans
  • Lorazepam
  • Methamphetamine* / adverse effects
  • Research

Substances

  • Methamphetamine
  • Lorazepam
  • Central Nervous System Stimulants