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Electroconvulsive Therapy for Catatonia in Children and Adolescents.

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Electroconvulsive Treatment for Catatonia in Autism Spectrum Disorders.

Nisha Withane1, Dirk M Dhossche2

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Child and Adolescent Psychiatric Clinics of North America
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Summary

Catatonia is increasingly seen in autism spectrum disorder (ASD). Electroconvulsive treatment (ECT) is recommended for ASD patients unresponsive to medical treatments, with maintenance ECT being crucial.

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Area of Science:

  • Neurology
  • Psychiatry
  • Developmental Neuroscience

Background:

  • Catatonia is a complex neuropsychiatric syndrome.
  • Increasing recognition of catatonia in autism spectrum disorders (ASD).
  • Challenges in assessing and diagnosing catatonia in ASD populations.

Purpose of the Study:

  • To review assessment, diagnosis, and treatment of catatonia in ASD.
  • To highlight the role of electroconvulsive treatment (ECT) in refractory cases.
  • To emphasize the need for further research.

Main Methods:

  • Review of current literature on catatonia in ASD.
  • Presentation of two new case vignettes illustrating assessment and treatment.
  • Discussion of pharmacological and non-pharmacological interventions.

Main Results:

  • Catatonia in ASD requires careful diagnostic consideration.
  • Lorazepam or benzodiazepine trials are initial medical treatments.
  • Electroconvulsive treatment (ECT) is a viable option for treatment-resistant catatonia in ASD.
  • Maintenance ECT may be important for sustained recovery.

Conclusions:

  • Catatonia is a significant concern in ASD, necessitating specialized approaches.
  • ECT should be considered for patients with ASD-related catatonia who do not respond to standard medical therapies.
  • Urgent need for prospective studies and controlled treatment trials for catatonia in ASD.