Treatment Outcomes in Catatonia: An Observational Study

Introduction: Catatonia is a distinct neuropsychiatric syndrome and often a psychiatric emergency. Available treatment includes Lorazepam and/or Electroconvulsive therapy. This study aimed to explore the phenomenology and treatment outcomes of catatonia inour context. Methods: This is an observational cohort study conducted over 12 months (April 2019 to March 2020). Patients admitted to the Department of Psychiatry, with a diagnosis of catatonia according to DSM-5 criteria, were studied. Data on demographics, comorbidities, catatonic signs, duration of catatonia, treatment response, remission of catatonia, and duration of hospital stay were collected. Numerical variables were summarized by median and interquartile range (IQR), and categorical variables with proportions. Results: Of the 27 enrolled patients, 17 (62.96%) were female, and the median age was 22 (IQR 19.25-27.25) years. The most common catatonic sign was mutism. The median Bush Francis Catatonia Rating Scale score at admission was 15 (IQR 10-22). All patientsreceived lorazepam, and of these, 13 (76.4%) responded as well as achieved remission. No patients received ECT as the first treatment modality. The median dose and time of lorazepam to respond were 4 (IQR 3-7) mg and 2 (IQR 1-3) days, respectively. The mediandose and time of lorazepam for remission were 38.5 (IQR 23-109.25) mg and 11 (IQR 6-17) days, respectively. Conclusion: Low dose of lorazepam is an effective first-line treatment for catatonia in our setting. Additional research could provide more insight into how specific catatonic signs relate to the effectiveness of lorazepam.