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Gen Hosp Psychiatry. 2017 Sep;48:1-19. doi: 10.1016/j.genhosppsych.2017.06.011. Epub 2017 Jun 24.

Alternative treatment strategies for catatonia: A systematic review.

Author information

1
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: sbeach1@partners.org.
2
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
3
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.

Abstract

BACKGROUND:

Catatonia is a commonly encountered syndrome, affecting 10-20% of various psychiatric populations and carrying significant medical co-morbidities. However, there are few established alternative treatment strategies when benzodiazepines are ineffective and electroconvulsive therapy is unavailable.

OBJECTIVE:

The authors systematically review evidence for alternative treatment strategies for catatonia using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

METHOD:

The authors conducted a search of PubMed database from 1983 to August 2016 to identify articles. Eligible reports presented cases involving treatment of catatonia using modalities other than benzodiazepines or electroconvulsive therapy.

RESULTS:

The authors identified 72 articles, comprising 98 individual cases. N-methyl-d-aspartate-receptor antagonists, anti-epileptic drugs, and atypical antipsychotic agents appeared to have the largest number of reports supporting their effectiveness and safety in treating catatonia patients.

CONCLUSIONS:

Based on the case report literature, the authors propose an updated algorithm for catatonia treatment in cases where benzodiazepines fail and electroconvulsive therapy is not available.

[Indexed for MEDLINE]

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