Catatonia: treatment

First line: low dose benzodiazepines

• Lorazepam 1-2mg sublingual or intramuscular
• Diazepam
• Midazolam
• Alprazolam
• Oxazepam
• Flunitrazepam
• Temazepam

Second line: low dose benzodiazepines

Third line drugs

Third line neuromodulation

Maintenance treatment to prevent relapse

References

1. Rasmussen SA, Mazurek MF, Rosebush PI. Catatonia: our current understanding of its diagnosis, treatment and pathophysiology. World J Psychiatry 2016; 6:391-398. 
2. Rogers JP, Oldham MA, Fricchione G, et al. Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2023; 37:327-369. 
3. Jaimes-Albornoz W, Ruiz de Pellon-Santamaria A, Nizama-Vía A, Isetta M, Albajar I, Serra-Mestres J. Catatonia in older adults: a systematic review. World J Psychiatry 2022; 12:348-367.
4. Medda P, Toni C, Luchini F, Giorgi Mariani M, Mauri M, Perugi G. Catatonia in 26 patients with bipolar disorder: clinical features and response to electroconvulsive therapy. Bipolar Disord 2015; 17:892-901.
5. Hansbauer M, Wagner E, Strube W, et al. rTMS and tDCS for the treatment of catatonia: a systematic review. Schizophr Res 2020; 222:73-78.
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Related checklists

• Catatonia: clinical features
• Catatonia: medical causes
• Catatonia: drug-induced
• Catatonia: investigations