Electroconvulsive Therapy in Lorazepam Non-Responsive Catatonia

AIM To compare the efficacy of electroconvulsive therapy (ECT) with risperidone in the treatment of lorazepam non-responsive catatonia. MATERIALS AND METHODS Inpatients with non-affective catatonia (n= 18) non-responsive to at least five-day trial of lorazepam (6-8 mg/day) were randomised into two groups in a double blind randomised design. Written informed consent was obtained. Four were dropped from the trial as they were found to have depressive catatonia. One group received true ECT (thrice weekly, n=8) plus oral placebo while the other received sham ECT plus risperidone (4-6 mg/ day). Bush-Francis Catatonia Rating Scale (BFCRS) was administered twice weekly to assess improvement in catatonic symptoms over a period of three weeks. The two groups were compared using two-way RMANOVA. RESULTS BFCRS scores reduced markedly over treatment course and this reduction was more profound in the ECT group (p=0.035). Shorter the duration of illness greater was the response (lower scores of BFCRS). CONCLUSIONS Superior clinical efficacy of ECT over neuroleptics in catatonia is confirmed by this randomized clinical trial.