title: Rapid relief of catatonia in mood disorder by lorazepam and diazepam.
abstract: BACKGROUND
  Catatonia has risks of severe morbidity and mortality and needs early treatment. In this study, we investigated more patients to discuss the efficacy of this treatment in patients with major depressive disorder (MDD) or bipolar I disorder (BPI).
  
  
  METHODS
  During a period of 9 years, we identified 12 catatonic patients with mood disorder, with MDD (n = 10) and BPI (n = 2) in the emergency department, inpatient and outpatient units of a general hospital. The patients received intramuscular injection (IMI) of 2 mg lorazepam once or twice during the first 2 h. If intramuscular lorazepam failed, intravenous dripping (IVD) of 10 mg diazepam in 500 mL normal saline every 8 h for 1 day was prescribed.
  
  
  RESULTS
  Eight patients had full remission of catatonia after receiving one dose of 2 mg lorazepam IMI. Two patients needed two doses of 2 mg lorazepam IMI. Two patients with BPI recovered from catatonia using one dose of 10 mg diazepam IVD over 8 h after they failed to respond to two doses of 2 mg lorazepam IMI. The response rate to lorazepam IMI was 83.3%. All catatonic features remitted in 24 h with 100% response rate.
  
  
  CONCLUSIONS
  The lorazepam-diazepam treatment strategy is a safe and effective method to relieve catatonia in mood disorder within 1 day. Psychiatrist consultation is helpful for final diagnosis and rapid treatment of catatonia.
authors.affiliation: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yu-Chi
authors.initials: YC
authors.lastname: Huang
authors.forename: Chin-Chuen
authors.initials: CC
authors.lastname: Lin
authors.forename: Yi-Yung
authors.initials: YY
authors.lastname: Hung
authors.forename: Tiao-Lai
authors.initials: TL
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D002389:Catatonia / Q000175:diagnosis / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008140:Lorazepam; D003975:Diazepam