Treatment with benzodiazepines during an episode of catatonia may cut the risk of future catatonia in half, according to a
study in the
Journal of Affective Disorders.
Why It’s Relevant
Catatonia recurs in many patients who experience a catatonic episode; recurrence is associated with repeated hospitalizations, functional deterioration, and increased mortality. However, there is limited systematic evaluation of how treatments that patients receive during acute catatonic episodes influence the risk of recurrence.
By the Numbers
- Researchers analyzed the medical records of 205 adults who were hospitalized with catatonia between 2001 and 2021. Overall, 31% of patients experienced recurrence, with a median time to recurrence of 6.4 years.
- Benzodiazepines were associated with a 50% decreased risk of future catatonic episodes over the follow-up period.
- Antipsychotics were associated with a 64% lower risk of recurrence within 60 days of the index episode but more than double the risk of recurrence in the long run.
- Electroconvulsive therapy and mood stabilizers were not significantly associated with catatonia recurrence.
The Other Side
The study was confined to patients hospitalized in acute psychiatric or somatic settings and didn’t include those whose catatonia was managed in emergency departments or outpatient settings, which limits generalizability to the broader population with catatonia. In addition, the researchers didn’t capture data on catatonia severity, treatment rationale, treatment adherence, post-acute management decisions, maintenance treatments, dose adjustments, or treatment discontinuation.
Takeaway Message
The findings support the use of benzodiazepines as a first-line treatment option, the researchers said, adding that 88% of patients in this analysis received benzodiazepines either alone or in combination with another treatment. The nuanced, time-dependent effects seen with antipsychotics, meanwhile, warrant careful consideration when clinicians plan long-term maintenance treatment for patients.
Related Information
Source
Liliana Patarroyo-Rodriguez, et al. Catatonia treatments and risk of recurrence. Journal of Affective Disorders. Published online April 2, 2026. doi: 10.1016/j.jad.2026.121734
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