Resources on Treatments
Treatment in General
Scholarly Articles
2023
British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia.
Rogers JP et al. Journal of Psychopharmacology
2023
Key recommendations from the British Association for Psychopharmacology (BAP) Catatonia Guideline, published in April 2023, emphasizing points from the guidelines that are of relevance to general physicians.
Rogers JP et al. Clinical Medicine Journal
2023
Evidence-based consensus guideline on the management of catatonia by the British Association for Psychopharmacology.
Rodriguez L Psychopharmacology Institute
2018
Review of published articles which examined the effects of interventions for catatonia in adult populations. Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature.
Pelzer ACM et al. Neuropsychiatric Disease and Treatment
2014
Authors aimed to (1) describe treatment used in a large sample of young inpatients with catatonia, (2) determine factors associated with improvement and (3) benzodiazepin efficacy.
Raffin M et al. European Child & Adolescent Psychiatry
2011
Clinical features and treatment response in 25 patients with catatonia admitted to an inpatient psychiatric unit. ECT, benzodiazepines, and clozapine had beneficial effects. Typical antipsychotics resulted in clinical worsening.
England ML et al. The Journal of Neuropsychiatry and Clinical Neurosciences
2007
If medical conditions precipitate catatonia, they are rarely its only etiology. The treatment of catatonia must be a priority to allow in parallel the specific treatment for the somatic disorder or the psychiatric disorder.
Cottencin O et al. Progress in Neuro-Psychopharmacology & Biological Psychiatry
2003
Aim of study - to compare the efficacy of ECT with risperidone in the treatment of lorazepam non-responsive catatonia. Superior clinical efficacy of ECT over neuroleptics in catatonia is confirmed by this randomized clinical trial.
Grish K & Gill NS Indian Journal of Psychiatry
2000
Lee JWY et al. Annals of Clinical Psychiatry
1996
Testing the efficacy of benzodiazepines and ECT and define a lorazepam test with predictive value for treatment. Lorazepam and ECT are effective treatments for catatonia. The rating scale has predictive value and is sensitive to change in clinical status.
Bush G et al. Acta Psychiatrica Scandinavica
Lorazepam
Scholarly Articles
2023
Effect of lorazepam in the treatment of catatonia is outstanding and almost immediate. Promote the rapid use of lorazepam in the treatment of acute catatonic patients.
Hirjak D et al. Schizophrenia Research
2023
Study results showed an incredible response in patients with catatonia only on lorazepam.
Latke R et al. Journal of Neurosciences in Rural Practice
2017
The lorazepam-diazepam protocol could rapidly and effectively relieve catatonia due to general medical condition and substance.
Lin C-C et al. PLOS ONE
2010
Response rate of lorazepam in catatonia in India was reviewed. 68.7% treated with lorazepam showed improvement in symptoms. 32.3% showed complete resolution. Lorazepam is cost effective and rapidly relieves catatonic signs.
Tibrewal P et al. Progress in Neuro-Psychopharmacology and Biological Psychiatry
2001
Summary of the results of benzodiazepine treatment response studies in catatonic movement disorders with particular reference to the authors' own studies in Chinese patients with catatonia.
Ungvari GS et al. European Archives of Psychiatry and Clinical Neuroscience
Electroconvulsive Therapy (ECT)
Scholarly Articles
2023
Case of a 70 year patient who was a retired chemist with catatonia and treated with ECT whose higher-level cognitive functions signifcantly improved as the sessions progressed.
Amad A The Journal of ECT
2023
Electroconvulsive therapy (ECT) with ketamine induction for catatonia in an HIV positive patient (Abstract)
Patient with catatonia and ECT had poor response to ECT with propofol induction. Subsequent use of ketamine as an anesthetic induction agent for ECT showed improvement in seizure quality, and good overall clinical response to ECT.
Nel Y & Bracken CA South African Journal of Psychiatry
2022
Case report - catatonia can be a major cause of developmental regression in patients with Down syndrome and offers an example of a promising management strategy for treatment.
Anthonio G et al. Cureus
2023
Brisk identification of potentially life-threatening NMS and NMS-like states, including malignant catatonia, warrants a trial of ECT.
Katzell L et al. Frontiers in Psychiatry
2020
A review of the literature on ECT as a treatment for catatonia as well as strategies for improving access to ECT for patients with catatonia and an algorithm for the treatment of catatonia with ECT.
Lloyd JR et al. Neuropsychiatric Disease and Treatment
2019
Current status, assessment, and treatment of pediatric catatonia are discussed.
Dhossche DM & Withane N Child and Adolescent Psychiatric Clinics of North America
2018
ECT is well-tolerated and efficacious treatment for agitated catatonia.
Wachtel LE et al. Current Opinion in Psychiatry
2017
2016
​Review of the indication for ECT in general, growing evidence supporting the use of maintenance ECT to prevent relapse, support for ECT for patients under the age of 18, and efforts to monitor and reduce memory loss.
Weiner RD & Reti IM International Review of Psychiatry
Review of optimal ECT treatment for patients diagnosed with catatonia, whether expressed as retarded, malignant, excited/delirious, repetitive self-injurious behavior in adolescents with autism or cognitive impairment, anti-NMDA receptor encephalitis, lupus, or other autoimmune diseases.
Fink M et al. The Journal of ECT
2010
Investigation of treatment characteristics and outcomes of patients with catatonia who were treated with ECT.. Daily administration of ECT may be more effective, whereas longer duration of seizure activity at the final ECT session was related to better response to ECT.
van Waarde JA et al. Journal of ECT
2010
Review of the literature (1985-2009) to clarify issues related to the use of ECT in child and adolescent patients with catatonia. ECT is a safe and effective treatment for catatonia in children and adolescents.
Consoli A et al. Journal of ECT
2010
Brief review of the diagnosis and treatment of catatonia and ssues surrounding ECT, cardiac effects, use of muscle relaxants, and the consent process.
Zisselman MH & Jaffe RL American Journal of Psychiatry
2001
ECT for Prolonged Catatonia (Abstract)
Three cases of prolonged catatonia with medical complications or comorbidities treated by ECT. ECT may improve prolonged catatonia with complex medical comorbidities, but may require many treatment sessions.
Malur C et al. The Journal of ECT
Books
2020
Shocked: Insider Stories about Electroconvulsive Therapy
Kirov G
2019
The ECT Handbook
Ferrier N and Waite J RCPsych Publications
2019
Handbook of ECT: A guide to Electroconvulsive Therapy for Practitioners
Kellner C Cambridge University Press
2019
Principles and Practice of Electroconvulsive Therapy
Rasmussen KG American Psychiatric Publishing Inc
2018
The Electroconvulsive Therapy Workbook: Clinical Applications
Weiss A. Routledge
2014
Is ECT Right for You?: A “Friend to Yourself” Resource
Johnson-Quijada S
2013
Electroconvulsive Therapy in Children and Adolescents
Ghaziuddin N (Ed) & Walter G (Ed) Oxford University Press
2012
Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness
Shorter E and Healy D Rutgers University Press
2010
Will I Ever Be the Same Again? Transforming the Face of ECT (Shock Therapy)
Kivler C Three Gem Publishing
2010
Clinical Manual of Electroconvulsive Therapy
Mankad MV et al. American Psychiatric Publishing Inc
2009
Electroconvulsive and Neuromodulation Therapies
Swartz, C. (Ed.). Cambridge: Cambridge University Press.
2009
Electroconvulsive Therapy: A Guide for Professionals and Their Patients
Fink M Oxford University Press
2007
Shock: The Healing Power of Electroconvulsive Therapy
Dukakis K & Tye L. Avery
Videos
2022
Michigan Medicine
2001
Nuland S TED2001
Podcasts
2023
Northwell Health
Challenges to ECT
Scholarly Articles
2023
Reasons hindering the use of ECT in certain patient groups, overview on the use of ECT to treat catatonia and provide practical advice on ECT in children, adolescents, and geriatric patients for the treatment of catatonia.
Karl S et al. Schizophrenia Research
2023
ECT is rarely utilized in the inpatient treatment of child and adolescent patients, but is most often administered to patients with mood and psychotic disorders. Commercial insurance and higher income were associated with higher odds of ECT administration, suggesting that access to care may be limited.
Luccarelli J et al. General Hospital Psychiatry
2023
Case that highlights the effectiveness of ECT in pediatric catatonia as well as difficulty initiating ECT in these patients.
Hua T & Cooper JJ The Journal of ECT
Treatment Specific to Anti-NMDA Receptor Encephalitis
Scholarly Articles
2023
Catatonia is a symptom of anti-NMDAR encephalitis which can evolve rapidly into malignant catatonia. Although early immunomodulatory therapy is important to treat the underlying autoimmune disorder, resistant catatonia may require adjuvant management with ECT.
Wadi L & Mandge V Neurology
2023
Retrospective case series shows ECT modality to be highly effective and safe adjuvant therapy for all forms of catatonic syndrome of confirmed or suspected immune origin.
Sanghani SN et al. Journal of Affective Disorders Reports
2023
Case Report of a 22-year-old male patient with a history of prodromal flu-like symptoms followed by brief aggression episodes, paranoid symptoms, and stereotypic movements. Our case suggests that ECT may be an effective treatment option for patients with anti-NMDA encephalitis.
Salcini C et al. Journal of Biomedical Research and Environmental Sciences
Other Treatment Possibilities
Scholarly Articles
2023
Study of alternative options other than lorazepam and ECT for pediatric catatonia. Alternative pharmacologic interventions for catatonia include valproic acid, NMDA receptor antagonists, and atypical antipsychotics.
Smith JR et al. Frontiers in Child & Adolescent Psychiatry
2023
Case report of memantine improving the symptoms of an MDD patient with treatment-resistant catatonia who did not respond to ECT and high doses of benzodiazepines.
Tanifuji T et al. PCN Reports
2023
Case of a geriatric patient with catatonia who had an insufficient response to benzodiazepines and cardiac contraindications to ECT.
Wendt L et al. Hospital Pharmacy
2023
Case report of woman who suffered from PTSD 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.
Bonomo N et al. BMC Psychiatry
2023
ECT, rTMS, and tDCS were effective in treating catatonia.
Xiao H et al. Frontiers in Psychiatry
2023
Case study highlights a potential use of sublingual ketamine and esketamine nasal spray as a treatment option in patients with chronic catatonia when other treatment choices fail to be effective.
Gregor E & Zheng W The American Journal of Case Reports
2023
2023
Case report of a child who was resistant to both lorazepam and electroconvulsive therapy. Resistance to both first-line management is a rare phenomenon. We were able to manage with a combination of antipsychotics and antidepressants.
Jha A Journal of the Nepal Medical Association
2023
Results of transcranial magnetic stimulation of dorsolateral prefrontal cortex (DLPFC) in four patients with catatonia. The influence of TMS on local brain regions makes it possible to achieve a positive clinical effect in treatment of catatonia.
Zakharova NV et al. Personalized Psychiatry and Neurology
Given the limited availability of ECT and the unclear utility of lorazepam for hyperactive catatonia in autism, the use of long-acting benzodiazepines and/or midazolam infusion may offer a safe and relatively available treatment alternative.
Smith JR et al. Journal of Child and Adolescent Psychiatry
2022
In this systematic review, the authors aimed to assess the evidence for clozapine as a treatment for catatonia.
Saini A et al. Schizophrenia Research
2022
Case of catatonia in a 16-year-old male with first onset psychosis successfully managed with a combination of lorazepam and clozapine. Engaging effectively with patient’s family is important to identify and manage catatonia in children.
Vargas JG et al. Psychiatry Research Case Reports
2022
tDCS may be used successfully in treatment-resistant patients, while awaiting ECT or for ECT-dependent catatonia.
Haroche et al. Frontiers in Psychiatry
2020
There are indications that atypical antipsychotics may be useful in non-malignant catatonia. Caution is advisable, since cases of neuroleptic malignant syndrome have been linked to treatment with atypical antipsychotics.
Van Den Eede F. et al. European Psychiatry
2020
Literature review: rTMS and tDCS might be promising alternative treatment strategies for patients with Catatonia.
Hansbauer M et al. Schizophrenia Research
2017
Review of evidence for alternative treatment strategies for catatonia. Authors propose an updated algorithm for catatonia treatment in cases where benzodiazepines fail and ECT is not available
Beach SR et al. General Hospital Psychiatry
2014
A reexamination of flurothyl infusions holds promise for improved resolution of severe mood disorders, as well as for a greater understanding of the mechanism of their pathophysiology.
Fink M & Shorter E. Psychiatric Times
2009
Clinical presentation of catatonia, subtypes and differential diagnosis, neurobiology of catatonic symptoms, diagnosis, underlying cause, and various treatments.
Daniels J The Journal of Neuropsychiatry and Clinical Neurosciences
2006
4 cases of catatonia (in patients with schizophrenia or bipolar disorder) in which topiramate treatment was used. Benzodiazepines were proven refractory. In all cases, subjects experienced complete remission of catatonic symptoms and tolerated treatment well.
McDaniel W et al. The Journal of Neuropsychiatry & Clinical Neurosciences
Recurrence of Catatonia
Scholarly Articles
2023
The report suggests that 17-19% of all cases diagnosed as catatonia due to other medical conditions are medication-induced. Case of a patient with catatonia associated with long-acting injectable paliperidone intramuscular therapy in a patient with schizophrenia.
Johnson BO et al. Cureus
2011
There is not much literature on patients requiring long-term maintenance of lorazepam for catatonia. The authors present a case of recurrent catatonia in which symptoms relapsed whenever an attempt was made to taper off of lorazepam.