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Advancing Integrated Psychiatric Care
for the Medically Ill

Catatonia

Clinical Monograph:  Catatonia in Medically Ill Patients

An Evidence-Based Medicine (EBM) Monograph
for Psychosomatic Medicine Practice

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Published jointly by the:

and

Version 4.17.2015

Authors/Workgroup:
Lex Denysenko
Oliver Freudenreich
Kemuel Philbrick
Thomas Penders
Paula Zimbrean
Shamim Nejad
Lydia Chwastiak
Anna Dickerman
Shehzad Niazi
Jewel Shim
Wolfgang Soellner
Audrey Walker

Invited external reviewers:
Brendan Carroll
Andrew Francis


EVIDENCE-BASED MEDICINE SUMMARY

  • INTRODUCTION
    • Objective and methods
    • Definition and diagnostic criteria
    • Differential diagnosis
    • Catatonia and delirium
    • Malignant catatonia
  • PEDIATRIC CATATONIA
    • Introduction
    • Occurrence
    • Co-occurrence with Autism Spectrum Disorder
    • Assessment and Rating Scales
    • Treatment of Pediatric Catatonia
  • ADULT CATATONIA
    • Occurrence and Etiology
  • MEDICAL CONDITIONS ASSOCIATED WITH CATATONIA
    • Anti-NMDA-receptor Encephalitis (ANRE)
    • Paraneoplastic Limbic Encephalitis
    • Systemic Lupus Erythematous (SLE)
    • Seizures
    • Brain infections
    • Intracranial Mass Lesions
    • Multiple Sclerosis
    • Delirium (Encephalopathy)
    • Glucose-6-phosphate dehydrogenase (G6PD) Deficiency
    • Vitamin B12 Deficiency
    • Hyponatremia
    • Stroke, Dementia, and Other Brain Degeneration Disorders
    • Takotsubo Cardiomyopathy
    • Wilson's Disease
    • Special Note on Ferropenia
  • DRUG TOXIDROMES AND WITHDRAWAL SYNDROMES ASSOCIATED WITH CATATONIA
    • Tacrolimus and Cyclosporine
    • 3,4-methylenedioxy-N-methylamphetamine (MDMA)
    • Steroids
    • Antibiotics
    • Disulfiram
    • GABA agonist withdrawal
    • Baclofen
    • Dopamine antagonists
    • Cocaine withdrawal
    • Phencyclidine (PCP)
    • Methoxetamine
  • TREATMENT OF CATATONIA
    • GABA agonists
    • NMDA Receptor Antagonists
    • Minocycline
    • Antipsychotics
    • ECT
    • Other Treatments
  • CONCLUSIONS

REFERENCES

APPENDIXES

  1. Recommended Readings
  2. Glossary of Terms
  3. Annotated List of Important Pharmacologic Trials
  4. Standardized Assessment and Work-Up
    •       Introduction
    •       Proposed Screen for Catatonia in the Medically Ill
    •       Assessment and Examination
    •       Pharmacologic Challenge
    •       Initial Recommendations to the Primary Service
    •       Definitive Treatment

Catatonia in Medically Ill Patients

Main  |  EBM Summary  |  References  |  Appendixes: A B C D

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