Catatonic syndrome : treatment response to Lorazepam

In a prospective open trial, 30 inpatients with catatonic signs were treated systematically with oral lorazepam (dosage ranging between 3 to 8 mg/d) for a period of 5 days and subsequently with ECT if lorazepam trial failed. Outcome was monitored quantitatively during the treatment phase with Bush-Francis catatonia rating scale. In 21 out of 30 patients (70%), catatonic signs resolved with lorazepam trial. The response to lorazepam on Day 1, predicted the final outcome. Demographic variables, severity of catatonia or length of catatonic syndrome prior to treatment did not have any predictive value. Majority of the patients who showed an unfavourable response, did well with electroconvulsive therapy. A short duration lorazepam administration proved to be a safe and effective treatment for the catatonic syndrome.