Catatonia: an open prospective series with carbamazepine

In view of reports in the literature that catatonia responds well to benzodiazepines, and the possible association between catatonia and seizure disorders, an open prospective study was conducted to explore the possibility that catatonia may be successfully treated with carbamazepine. Patients meeting DSM-IV criteria for catatonia were challenged with lorazepam IMI and their response assessed. Non-responders, partial responders and patients who had a recurrence of symptoms were put on a trial of carbamazepine and their response assessed. Nine patients were assessed at our unit. Six of the 9 had a complete, but transient response to lorazepam. All of the patients were given a trial of carbamazepine: 4 had a complete resolution of catatonic symptoms, 1 had a partial resolution and 4 patients did not show a significant improvement. Carbamazepine seems to be an effective treatment, both in the acute phase, and as maintenance in a subgroup of retarded catatonic patients.