The Rationale for, and Use of, Benzodiazepines in Catatonia

This article reviews the rationale for, and the mechanisms of action of, benzodiazepines (BZs) in the treatment of catatonia, a potentially lethal neuropsychiatric condition that disrupts affect, behavior, cognition, and motor functioning. Following a case presentation that highlights the typical manifestations of catatonia, strategies for refining the diagnosis and approaching treatment decisions are discussed. In addition, the use of lorazepam as a diagnostic tool is discussed, as are the indications for the maintenance, tapering, and discontinuation of lorazepam. Adverse effects and contraindications of BZs, along with alternative treatment approaches for those with catatonia, are also presented to guide treatment decisions, which are of critical importance in patients with co-morbid medical and neurological conditions.