Clinical manifestations, diagnosis, and empirical treatments for catatonia.
OBJECTIVE
Review the medical literature on the history and clinical features of catatonia so as to provide a contemporary clinical guide for successfully diagnosing and treating the various clinical forms of catatonia.


METHODS
RESULTS of MEDLINE computerized searches using search terms 'catatonia', 'treatment of catatonia', 'electroconvulsive therapy and catatonia', 'benzodiazepines and catatonia', clinical case reports, and book chapters covering the medical and psychiatric literature relevant to catatonia and its associated treatments were examined.


METHODS
Academic medical center.


METHODS
None.


METHODS
None.


RESULTS
Catatonia is a common but under-recognized clinical syndrome. No large-scale, controlled studies exist to determine the relative effectiveness of current treatments, including sedative-hypnotic medications (benzodiazepines or barbiturates), and electroconvulsive therapy (ECT).


CONCLUSIONS
Despite the lack of large-scale, controlled studies, benzodiazepines appear to be an effective first-line treatment for catatonia. ECT is now often reserved as a second-line treatment despite more than 60 years of documented efficacy and safety. However, ECT should be viewed as a first-line intervention in cases of severe or malignant catatonias.
Bhati
Mahendra T
MT
Department of Psychiatry, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. mbhati@bbl.med.upenn.edu
Datto
Catherine J
CJ
O'Reardon
John P
JP
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