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Volume 7, Issue 5 (Suppl) J Psychol Psychother, an open access journal
ISSN: 2161-0487 Psychosomatic Medicine & Forensic Congress 2017
October 12-14, 2017
JOINT EVENT
24th International Conference on PSYCHIATRY & PSYCHOSOMATIC MEDICINE
2nd International Congress on FORENSIC SCIENCE AND PSYCHOLOGY
&
October 12-14, 2017 London, UK
Catatonia - A "Frozen Condition?": Case reports, literature review, and suggested treatment algorithm
Cris Coconcea1 and N Coconcea2
1Christiana Care Health System, USA
2Case Western Reserve University School of Medicine, USA
Background: According to recent statistics, 5–9% of all psychiatric inpatients show some catatonic symptoms. Among which 25–50%
are associated with mood disorders, 10–15% are associated with schizophrenia, and the remainder are associated with other mental
disorders. Recent developments in the treatment of catatonia are raising the GABAa vs. GABAb hypothesis of catatonia.
Methods: This paper describes 7 cases of benzodiazepine-resistant catatonia responding to treatment with zolpidem and critically
reviews the current literature on the treatment of catatonia, proposing an algorithm for the diagnosis and treatment of this condition.
Results:All 7 patients in this report are showing similar catatonic symptoms, lack of response (or partial response) to other treatments,
and same patterns of response to zolpidem, including an initial zolpidem challenge test. From the review of the literature on catatonia,
there is growing evidence suggesting the role of GABAa agonists in the treatment of catatonia, as well as for the possible pro-catatonic
effect of the GABAb agonists, with important potential clinical applications in the treatment of this severe condition.
Conclusions: Zolpidem, a GABAa specific agonist appears to be a new and safe therapeutic approach for catatonia, potentially useful
in benzodiazepine-resistant patients. More research will be needed to replicate and further understand the mechanism and sites
of its activity. Various agents described in the literature as useful for the management of catatonia are critically reviewed in terms
of mechanism of activity and strength of evidence, and an evidence-based algorithmic approach to the diagnosis and treatment of
catatonia is proposed.
Biography
Cris Coconcea, M.D is director of psychiatry residency training program at Christiana Care Health System in Wilmington, DE, and Clinical Assistant Professor of
Psychiatry at CWRU School of Medicine in Cleveland, OH. His clinical, research interests and presentation topics include catatonia, psychotic disorders and acute
inpatient psychiatry. He has lectured extensively at local, national and international conferences.
Nicole Coconcea, MD is medical director of integrated care in psychiatry and geriatric psychiatrist at Christiana Care Health System in Wilmington, DE, and Clinical
Assistant Professor of Psychiatry at CWRU School of Medicine in Cleveland, OH. Her clinical, research interests and presentation topics include integrated care
and medical comorbidities of the geriatric psychiatric patient
Cris Coconcea et al., J Psychol Psychother 2017, 7:5(Suppl)
DOI: 10.4172/2161-0487-C1-017