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The use of atypical antipsychotics in the treatment of catatonia

Published online by Cambridge University Press:  16 April 2020

Filip Van Den Eede ,
Jan Van Hecke ,
Arjen Van Dalfsen ,
Bart Van den Bossche ,
Paul Cosyns  and
Bernard G.C. Sabbe
Filip Van Den Eede*
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium University Hospital Antwerp, UZA, Edegem, Belgium
Jan Van Hecke
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium Campus Stuivenberg, ACZA, Antwerp, Belgium
Arjen Van Dalfsen
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium Mental Health Care WNB, Bergen op Zoom, The Netherlands
Bart Van den Bossche
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium University Hospital Antwerp, UZA, Edegem, Belgium
Paul Cosyns
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium University Hospital Antwerp, UZA, Edegem, Belgium
Bernard G.C. Sabbe
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, CAPRI, University of Antwerp (UA), Campus Drie Eiken/Building T, Universiteitsplein 1, 2610Antwerp, Belgium Psychiatric Hospital St.-Norbertushuis, Duffel, Belgium
*
*Corresponding author. Tel.: +32 3 820 2328. E-mail address: filip.vandeneede@ua.ac.be (F. Van Den Eede).
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Abstract

Purpose

Evidence indicates that classical antipsychotics may aggravate non-malignant and malignant catatonia (MC). Atypical antipsychotics are less likely to cause movement disorders than classical antipsychotics and they are being frequently prescribed in disorders that can be associated with catatonia. Therefore, the important question that arises is whether atypical antipsychotics have a role to play in the treatment of catatonia.

Materials and methods

A Medline search was performed to locate papers on the use of atypical antipsychotics in catatonia published between 1970 and 31st December 2004.

Results

The literature on the use of atypical antipsychotics in catatonia consists of case reports and retrospective studies. In most cases of non-MC a reduction of the catatonic symptoms is reported upon treatment with atypical antipsychotics. Cases of MC relate mainly to the neuroleptic malignant syndrome (NMS), which is considered as an iatrogenic stuporous variant of MC caused by antipsychotics.

Conclusion

There are indications that atypical antipsychotics may be useful in non-MC. As a consequence, one should not only focus on the possible extrapyramidal and autonomic side effects of these drugs, but also on the possible beneficial effects on certain brain functions and on the catatonic symptomatology. However, randomized controlled trials are needed to evaluate the effect of these drugs, and caution is advisable, since cases of NMS have been linked to treatment with atypical antipsychotics. There is no evidence to prescribe atypical antipsychotics in MC.

Keywords

CatatoniaLethal catatoniaMalignant catatoniaNeuroleptic malignant syndromeAtypical antipsychotics
Type
Review
Information
European Psychiatry , Volume 20 , Issue 5-6 , August 2005 , pp. 422 - 429
Copyright
Copyright ©Elsevier SAS 2005

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Footnotes

Abbreviations: ECT, electroconvulsive therapy; MC, malignant catatonia; NMS, neuroleptic malignant syndrome; non-MC, non-malignant catatonia.

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