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The Most Effective Treatments for Catatonic States

written by: Daniel P. McGoldrick • edited by: Paul Arnold • updated: 8/30/2010

What is a catatonic state and which treatment methods have mental health professionals determined, over the years, to be the most effective methods for treating a patient with this unique, rare, and debilitating mental and physical state of being? Discover the answers here.

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    What Is a Catatonic State?

    Before we get into the most effective catatonic states treatment options, it’s important to define the condition and its ramifications first. A catatonic state (known as catatonia) refers to a patient who is experiencing disturbances of motor behavior that is due to either psychological or neurological causes. It's most commonly recognized when a person exhibits rigid, immobile postures as if they were in a frozen stupor that can last extensive lengths of time from days to months. In short and in laymen’s terms, the patient will resemble a motionless zombie who isn’t present mentally, and has seemingly lost the power or will to move his or her body.

    However, catatonia can also be marked by excessive motor activity that appears purposeless, as if the patient is agitated by an external trigger, yet there is no external trigger present. Therefore, a catatonic person can demonstrate quite opposite symptoms, either a total motor deficit, or excitement which can include violent behavior toward themselves or others. Often, people suffering from this condition will also repeat words and phrases almost parrot-like.

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    Treatments Known to be Effective for Patients in Catatonic States

    This condition is, in most cases, associated with mental illnesses such as schizophrenia, and mood disorders such as Bipolar I and II, as well as deep depression. Therefore treatment plans must also involve caring for those mental illnesses as well. The characteristics of catonia can also be seen in Neuroleptic Malignant Syndrome (NMS). This alarming syndrome results from an uncommon but potentially lethal reaction to certain medications used to treat very serious mental illnesses. That's why doctors proceed with caution in administering drugs to the catatonic.

    Because the causes of catatonia are largely unknown, treating it can differ with each catatonic patient. Since there really are no known preventative measures to keep a person from entering a catatonic state, all treatments necessarily revolve around dealing with a mental health patient who is already in one. Catatonic schizophrenia and other forms of catatonia require consistent, ongoing treatment and careful observation by well trained medical professionals who know what they’re dealing with. Medications are the primary choice for medical professionals handling cases of catatonia.

    The treatments available to treat catatonic individuals include benzodiazepines which are known as a first-line treatment strategy. Benzodiazepines (commonly known as Benzos) are a family of drugs that are used as sedatives and for their anti-anxiety effects. When Benzos are ineffective, NMDA has been known to work as well. Barbituates are used for catatonic schizophrenia. Other medications used to manage symptoms on a case-by-case basis may include antidepressants and mood-stabilizers, but usually not antipsychotics because they can actually increase symptoms

    Electroconvulsive therapy (ECT) may be employed for very severe catatonic schizophrenia. ECT delivers electrical currents through the brain to produce a desired beneficial result. For more about this procedure and its origins, read Exploring the History of ECT as a Mental Health Treatment. Psychotherapy is also part and parcel of ongoing treatment where a patient is able to communicate coherently. Therapy will assist the patient cope with this disruptive disorder, ensure that medications are being taken correctly, and provide living skills to handle the condition.