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Effective Treatment of Catatonia by Combination of Benzodiazepine and Electroconvulsive Therapy

Unal, Ahmet MD; Bulbul, Feridun MD; Alpak, Gokay MD; Virit, Osman MD; Copoglu, U. Sertan MD; Savas, Haluk A. MD

doi: 10.1097/YCT.0b013e3182887a1a
Original Studies

Objective Catatonia, a motor dysregulation syndrome, can emerge in numerous psychiatric disorders, mainly in schizophrenia and mood disorders, and metabolic and endocrine disorders such as infections, toxic states, epilepsy, and traumatic brain injury. In our study, we aimed to investigate demographic, clinical, and treatment-related characteristics of catatonic patients managed in our inpatient clinic.

Methods The medical records of 57 patients diagnosed to have catatonia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the inpatient psychiatry clinic of the Gaziantep University School of Medicine between 1 January, 2003, and 31 December, 2011, were retrospectively reviewed.

Results In patients with catatonia, mood disorders (63.2%) were found to be the most common underlying or primary disease, whereas mutism (47.4%) was found to be the most common catatonic symptom. There was a comorbid medical condition in 9 patients (15.8%). Patients underwent an average of 9.00 electroconvulsive therapy (ECT) sessions. Among 57 patients with catatonia, catatonic symptoms were resolved in 57 patients (100%) by benzodiazepine and ECT.

Conclusions In our study, full recovery was achieved in catatonia by benzodiazepine plus ECT combination. As a result, we recommend combined ECT and benzodiazepine for catatonia.

From the *Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep; and †Department of Psychiatry, Şanlıurfa Ceylanpınar State Hospital, Şanlıurfa, Turkey.

Received for publication October 11, 2012; accepted January 17, 2013.

Reprints: Ahmet Unal, MD, Department of Psychiatry, Faculty of Medicine, Gaziantep University, 27310 Şahinbey, Gaziantep, Turkey (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

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