Treatment of Catatonia With Olanzapine and Amantadine

Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia, United States
Psychosomatics (Impact Factor: 1.86). 11/2007; 48(6):534-6. DOI: 10.1176/appi.psy.48.6.534
Source: PubMed


Catatonia is a disorder characterized by mutism, posturing, echophenomena, and negativism. The preferred treatment for non-malignant catatonia is benzodiazepines, which often produce a reduction in symptoms within 24 hours. Presented here is a case report of a 19-year-old woman appearing in a catatonic state that did not respond to lorazepam. On the basis of emerging evidence that atypical antipsychotics and weak N-Methyl-D-Aspartate (NMDA) receptor-antagonists may effectively treat catatonia, we treated our patient with olanzapine and amantadine, which resulted in a dramatic reduction in her catatonic symptoms.

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    • "Another hypothesis related to pathophysiology of catatonia is the inhibition of the D2 receptors (Philbrick and Rummons 1994). Catatonia can be induced with atypical antipsychotics, although they have actually been found to be effective in the treatment of catatonia (Kopala and Caudle 1998; Duggal and Gandotra 2005; Babington and Spiegel 2007; Guzman et al. 2008). These studies suggest that dopamine regulation can be important in the treatment of catatonia. "

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    • "But our patient did not respond to lorazepam within 2 h. Recently, increasing reports on the use of atypical antipsychotics such as olanzapine may indicate their utility in treating some varieties of catatonia (Babington and Spiegel, 2007; Cassidy et al., 2001; DelBello et al., 2000; Dudova and Hrdlicka, 2008; Guzman et al., 2008; Nicolato et al., 2006; Tan et al., 2006). (Table 1) Moreover, olanzapine may increase appetite (Bhana et al., 2001) to improve his poor intake. "

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