Psychiatry & Psychotherapy Podcast Catatonia: Diagnosis and Treatment
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Feb 15, 2020 Michael Cummings, a seasoned psychiatrist and psychotherapist, expertly unpacks the complexities of catatonia. He shares its historical context and highlights its alarming symptoms, from mutism to stupor. Immediate diagnosis is crucial, with innovative tests like lorazepam aiding recognition. Cummings also discusses effective treatments, including benzodiazepines and electroconvulsive therapy, while differentiating between catatonia and conditions like delirium. Fascinating neuroimaging insights link catatonia to PTSD, suggesting shared brain functions.
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Catatonia Motor Syndrome Defined
- Catatonia is a motor syndrome with two main states: extreme purposeless agitation or profound stupor and mutism.
- Patients remain aware of their environment despite motor freezing in stuporous catatonia.
Lorazepam Challenge Diagnostic Tool
- Use lorazepam challenge (1-2 mg IV or IM) to diagnose catatonia early by observing quick awakening.
- A positive response strongly indicates catatonia, enabling fast and effective treatment.
Benzodiazepine Challenge Demonstration
- Dr. David Puder enjoys showing medical students dramatic lorazepam response in catatonia.
- Watching patients rapidly improve after Ativan bolsters clinical understanding and confidence.