Catatonia in the medically ill: Etiology, diagnosis, and treatment. The Academy of Consultation-Liaison Psychiatry Evidence-Based Medicine Subcommittee Monograph

Lex Denysenko, Nicole Sica, Thomas M. Penders, Kemuel L. Philbrick, Audrey Walker, Scott Shaffer, Paula Zimbrean, Oliver Freudenreich, Nicole Rex, Brendan T. Carroll, Andrew Francis

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

BACKGROUND: Catatonia in medically ill patients is rare but often unrecognized. This monograph summarizes current knowledge on the diagnosis, epidemiology, etiology, and management of catatonia occurring in the medical setting. METHODS: PubMed searches were used to identify relevant articles from 1962 to present. RESULTS: More than 3,000 articles were obtained and reviewed for relevance, including references of articles identified by the initial search. Several areas were identified as important, including: (1) catatonia and delirium; (2) malignant catatonia; (3) pediatric catatonia; (4) catatonia associated with another medical condition (CAMC); (5) drug exposure and withdrawal syndromes associated with catatonia; and (6) treatment of catatonia in the medical setting. CONCLUSIONS: Catatonia in the medically ill appears to have numerous etiologies, although etiology does not seem to modify the general treatment approach of prompt administration of lorazepam. Delirium and catatonia are commonly comorbid in the medical setting and should not be viewed as mutually exclusive. Electroconvulsive therapy should be offered to patients who do not respond to benzodiazepines or have malignant features. Removing offending agents and treating the underlying medical condition is paramount when treating CAMC. Memantine or amantadine may be helpful adjunctive agents. There is not enough evidence to support the use of antipsychotics or stimulants in treating CAMC.

Original languageEnglish (US)
Pages (from-to)140-155
Number of pages16
JournalAnnals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
Volume30
Issue number2
StatePublished - May 1 2018

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

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