Periodic catatonia with long-term treatment: a case report

BMC Psychiatry

Case Report

Tiao-Lai Huang¹  Ruei-An Chen¹ 

[1] Department of Psychiatry, Chang Gung Memorial Hospital– Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta-Pei Rd, Niao-Sung, 833, Kaohsiung, Taiwan;

关键词: Catatonia;    Lorazepam;    Daylight exposure;   

DOI  :  10.1186/s12888-017-1497-6

 received in 2016-08-07, accepted in 2017-09-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPeriodic catatonia has long been a challenging diagnosis and there are no absolute guidelines for treatment when precipitating factors are also unclear. We report a schizophrenia patient with periodic catatonia with a 15-year treatment course. A possible correlation between decreased daylight exposure and periodic attacks has been observed.Case presentationWe describe a 49-year-old woman with periodic catatonia associated with schizophrenia with 15 years of follow-up. The patient was treated with the antipsychotics risperidone, haloperidol, loxapine and quetiapine, but catatonia still relapsed once per year during the first few years of her disease course. The treatment was consequently been switched to clozapine due to fluctuated psychotic illness, and a longer duration of remittance was achieved. Lorazepam-diazepam protocol was used for rapid relief of catatonic symptoms, and was able to significantly shorten the duration of the symptoms. In addition, we observed a possible correlation between catatonic episodes and decreased daylight exposure during the 15-year duration.ConclusionsSuccessful treatment of acute periodic catatonia was achieved with a lorazepam-diazepam protocol, and the patient remained in remission for a longer duration under clozapine treatment. Besides, the possibility of decreased daylight exposure acting as a precipitating factor was observed during our 15 years of follow-up.

【 授权许可】

CC BY   
© The Author(s). 2017