ECT for prolonged catatonia

Chitra Malur, Elias Pasol, Andrew Francis

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objective and Background: Electroconvulsive therapy (ECT) is highly effective for acute catatonia but its use in prolonged catatonia is not well established. We report three cases of prolonged catatonia with medical complications or comorbidities treated by ECT. Method: Case reports. Results: A 24 year-old woman developed fever and autonomic instability after parenteral neuroleptics. Catatonia and autonomic signs persisted for 14 weeks. After minimal improvement from lorazepam, 15 bilateral ECTs led to resolution. A 26-year-old woman with a history of lupus erythematosus, complicated by lupus cerebritis with lesions in the cortex and basal ganglia and a communicating hydrocephalus, was catatonic for 9 weeks. Lorazepam produced marginal improvement. A series of 14 bilateral ECTs led to improved mobility, speech, and interaction, but the response was less robust than Case 1. A 40-year-old man with mental retardation and intermittent psychosis developed severe neuroleptic malignant syndrome and remained catatonic for 4 months. After lorazepam produced minimal improvement, his catatonia resolved with 20 bilateral ECTs. Conclusions: ECT may improve prolonged catatonia with complex medical comorbidities, but may require many treatment sessions. Gross cerebral pathology may predict a less robust response. As for acute catatonia, ECT may resolve prolonged catatonia after benzodiazepines have failed.

Original languageEnglish (US)
Pages (from-to)55-59
Number of pages5
JournalJournal of ECT
Volume17
Issue number1
DOIs
StatePublished - Apr 10 2001

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Catatonia
Electroconvulsive Therapy
Lorazepam
Comorbidity
Neuroleptic Malignant Syndrome
Hydrocephalus
Basal Ganglia
Benzodiazepines
Intellectual Disability
Psychotic Disorders
Antipsychotic Agents
Fever
Pathology

All Science Journal Classification (ASJC) codes

  • Neuroscience (miscellaneous)
  • Psychiatry and Mental health

Cite this

Malur, Chitra ; Pasol, Elias ; Francis, Andrew. / ECT for prolonged catatonia. In: Journal of ECT. 2001 ; Vol. 17, No. 1. pp. 55-59.
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ECT for prolonged catatonia. / Malur, Chitra; Pasol, Elias; Francis, Andrew.

In: Journal of ECT, Vol. 17, No. 1, 10.04.2001, p. 55-59.

Research output: Contribution to journalArticle

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AB - Objective and Background: Electroconvulsive therapy (ECT) is highly effective for acute catatonia but its use in prolonged catatonia is not well established. We report three cases of prolonged catatonia with medical complications or comorbidities treated by ECT. Method: Case reports. Results: A 24 year-old woman developed fever and autonomic instability after parenteral neuroleptics. Catatonia and autonomic signs persisted for 14 weeks. After minimal improvement from lorazepam, 15 bilateral ECTs led to resolution. A 26-year-old woman with a history of lupus erythematosus, complicated by lupus cerebritis with lesions in the cortex and basal ganglia and a communicating hydrocephalus, was catatonic for 9 weeks. Lorazepam produced marginal improvement. A series of 14 bilateral ECTs led to improved mobility, speech, and interaction, but the response was less robust than Case 1. A 40-year-old man with mental retardation and intermittent psychosis developed severe neuroleptic malignant syndrome and remained catatonic for 4 months. After lorazepam produced minimal improvement, his catatonia resolved with 20 bilateral ECTs. Conclusions: ECT may improve prolonged catatonia with complex medical comorbidities, but may require many treatment sessions. Gross cerebral pathology may predict a less robust response. As for acute catatonia, ECT may resolve prolonged catatonia after benzodiazepines have failed.

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