Catatonia successfully treated with lorazepam and clozapine in an adolescent with first episode psychosis: A case report

Vargas, Jessica Gisela; Silva, Bruno Fernando Borges da Costa e; Butler, Brenda J.; Meyerovitz, Claire; Waldman, Lauren

doi:10.1016/j.psycr.2022.100068

Cited by 1 publication

(2 citation statements)

References 27 publications

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“…Currently, the clinical evidence supporting the use of antipsychotics for catatonia is limited, indicating only some potential benefits [ 1 ]. However, there is a lack of sufficient scientific data, particularly when it comes to the child and adolescent population.…”

Section: Discussionmentioning

confidence: 99%

“…Stuporous catatonia is characterized by psychomotor retardation, rigidity, mutism, and staring, while excited catatonia is marked by prolonged periods of psychomotor agitation. Periodic catatonia may exhibit intermittent symptom resolution, whereas malignant catatonia represents a severe and potentially life-threatening form of the condition with exacerbations of catatonic symptoms and autonomic instability [ 1 ]. In assessing pediatric catatonia, similar symptomatology to adult cases has been considered using clinical rating scales originally designed for adults, such as the Bush-Francis Catatonia Rating Scale (BFCRS) [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Undiagnosed Schizophrenia With Catatonia in a Hispanic Adolescent: The Significance of Social Determinants in the Diagnosis and the Efficacy of Risperidone and Lorazepam in Treatment

Tedesco¹,

González²,

Owusu-Antwi³

et al. 2023

Cureus

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Catatonia is a potentially life-threatening motor dysregulation syndrome associated with various psychiatric, medical, or developmental conditions. It is not uncommon but rarely described in the pediatric population. The timely identification of catatonia is essential as the treatment approach differs from the differential diagnoses and possible underlying conditions. The social determinants of health are factors that may negatively impact psychological well-being, increase the risk and prevalence of mental disorders, and deteriorate the prognosis for those who already have them. The comprehension of social determinants of health is essential because it provides a deeper understanding of the complexity of societal structures and how they influence the lives of children and families. This case demonstrates how social determinants of health may contribute to misdiagnosis, delayed diagnosis, and an increase in the incidence of mental health disorders. We present a case report on a Hispanic adolescent with first-episode catatonia in the presence of disorganized, psychotic thoughts. The patient was successfully treated with the lorazepam challenge in conjunction with Risperidone M-Tab treatment in three days. The origin of catatonia was rooted in undiagnosed schizophrenia that had worsened over a year originating from a first-episode break that questions an untreated substance-induced psychosis: the substance is unknown, as her parents had not brought her to the emergency department at that time. The demographics of this patient have also placed her at risk for a lack of access and sociocultural aspects in the delay of treatment. Through this case report, we aim to highlight some critical points in diagnosing and managing nonmalignant catatonia in a demographically underserved minority adolescent female. This report emphasizes the need for more data about the etiology and treatment of catatonia, especially in the pediatric population.

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Section: Discussionmentioning

confidence: 99%