Possible effects of electroconvulsive therapy on refractory psychosis in primary progressive multiple sclerosis: A case report

Narita, Zui; Satake, Naoko; Sato, Wakiro; Takano, Harumasa

doi:10.1002/npr2.12014

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…She relapsed when her lorazepam was decreased only for one day and then appeared to be refractory to initial treatment again with lorazepam, which is unlikely for patients without underlying medical conditions. Our case, as well as the literature above, shows that the first-line treatments lorazepam and/or ECT are effective when the catatonia is secondary to demyelinating disease, but there is a potentially higher risk of relapses and resistance to treatment, and treatment for the demyelinating disease should also be considered concurrently [ 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 74%

Recurrent Catatonia and Demyelinating Disorders

Jiang,

Koepsell,

Patel

et al. 2023

Cureus

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Catatonia, a neuropsychiatric syndrome characterized by psychomotor and behavioral symptoms, can be associated with various underlying conditions, including demyelinating diseases such as multiple sclerosis. This paper presents a case study of a 47-year-old female with recurrent catatonic relapses and an underlying demyelinating disease. The patient exhibited symptoms of confusion, decreased oral intake, and difficulty with movement and speech. Neurological examinations, brain imaging, and laboratory tests were conducted to evaluate the etiology and guide treatment. The patient showed improvement with lorazepam and electroconvulsive therapy (ECT). However, relapses occurred after the abrupt withdrawal of medication. The case study highlights the potential connection between demyelinating diseases and catatonia and emphasizes the importance of considering demyelinating diseases in the workup, treatment, and relapse prevention of catatonia. Further research is needed to explore the mechanisms underlying the relationship between demyelination and catatonia and to investigate how different etiologies may impact the recurrence rates of catatonic episodes.

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Section: Discussionmentioning

confidence: 74%

Recurrent Catatonia and Demyelinating Disorders

Jiang,

Koepsell,

Patel

et al. 2023

Cureus

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Drug Treatment of Psychiatric Symptoms Occurring in the Context of Other Disorders

2021

The Maudsley Prescribing Guidelines in Psychiatry

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People living with human immunodeficiency virus (HIV) may experience symptoms of mental illness due to a variety of factors. Patients with advanced HIV disease are more likely to suffer exaggerated adverse reactions to psychotropic medication. People with epilepsy have elevated prevalence of several psychiatric disorders including depression, anxiety and psychosis. The commonest autosomal deletion is a multisystem disorder with a heterogeneous presentation which varies greatly in severity between affected individuals. Mental illness may present in unusual ways in learning disabilities, for example, depression as selfinjurious behaviour, persecutory ideation as complaints of being ‘picked on’. In people with multiple sclerosis (MS), depression is common with a point prevalence of 14‐31% and lifetime prevalence of up to 50%. There are no published trials for the drug treatment of anxiety in MS, but selective serotonin reuptake inhibitors can be used and in non‐responsive cases, venlafaxine might be an option.

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