Cannabis-Induced Catatonia: A Case Series

Abstract

Catatonia is a psychomotor condition characterized by physical presentations ranging from severe immobility to excessive psychomotor agitation with an array of accompanying emotional aspects. Though initially thought to be a subform of schizophrenia, it is now recognized to be associated with many different psychiatric, neurological, and medical diagnoses. The emergence of catatonia is becoming more prevalent with its changing pattern and extensive use of recreational and illegal drugs. With the legalization of marijuana, its use is on the rise leading to several mental health conditions, including catatonia. If left untreated, catatonia has a significant morbidity and mortality rate; hence, prompt evaluation and diagnosis are critical for the prevention of adverse events. Benzodiazepines (BZDs) and electroconvulsive therapy (ECT) have been found to be most effective and remained as the preferred treatment options. In this paper, we present the case of two patients who presented with catatonia after cannabis consumption and discuss their treatment course and management.

A prospective descriptive study on prevalence of catatonia and correlates in an acute mental health unit in Nelson Mandela Bay, South Africa

“…This means schizophrenia and bipolar disorder accounted for 80% of the underlying psychiatric causes in this cohort. These findings are consistent with the results of previous studies [23][24][26][27][28][29][30][31][32][33].…”

Cannabis-Induced Malignant Catatonia: A Medical Emergency and Review of Prior Case Series

“…Very little is known about this association and primarily through case reports. These case reports have been summarized in Table 1 [ 14 - 17 ].…”

Are benzodiazepines effective in treating catatonia?

“…The sensitivity and specificity are therefore unclear. Alternative tools to screen for and monitor the progression of catatonic signs and symptoms include the Bush–Francis Catatonia Rating Scale and the Northoff Catatonia Scale, both of which have been shown to be reliable and sensitive to change (Bush 1996a, 1996b; Northoff 1999). These tools were available at the time of the study and it remains unclear why these rating scales were not used.…”

“…This review highlights the paucity of RCTs on the use of benzodiazepines in catatonia, but this does not necessarily equate to a lack of an evidence base (Box 6). With case series (Petrides 1997;Mekala 2020;Neerukonda 2020) and observational studies (Raveendranathan 2012) demonstrating their efficacy, the use of placebo-controlled trials for an acute, life-threatening state could arguably be both dangerous and unethical. Although RCTs are held to be high-quality evidence (Fig.…”