Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives

Jenifer R Lloyd,1 Eric R Silverman,1 Joseph L Kugler,2 Joseph J Cooper1 1Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Psychiatry, University of Texas-Dell Medical School, Austin, TX, USACorrespondence: Jenifer R LloydDepartment of Psychiatry, Universi...

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Autores principales:	Lloyd JR, Silverman ER, Kugler JL, Cooper JJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	catatonia electroconvulsive therapy underdiagnosis algorithm Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ce2ca1e4df724d6397e360581cf3bac2
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spelling	oai:doaj.org-article:ce2ca1e4df724d6397e360581cf3bac22021-12-02T13:04:02ZElectroconvulsive Therapy for Patients with Catatonia: Current Perspectives1178-2021https://doaj.org/article/ce2ca1e4df724d6397e360581cf3bac22020-09-01T00:00:00Zhttps://www.dovepress.com/electroconvulsive-therapy-for-patients-with-catatonia-current-perspect-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Jenifer R Lloyd,1 Eric R Silverman,1 Joseph L Kugler,2 Joseph J Cooper1 1Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Psychiatry, University of Texas-Dell Medical School, Austin, TX, USACorrespondence: Jenifer R LloydDepartment of Psychiatry, University of Illinois at Chicago, 912 S Wood St (MC 913), Chicago, IL 60612, USATel +1 312-996-0906Fax +1 312-996-9517Email jlloyd5@uic.eduAbstract: Catatonia is a serious, common syndrome of motoric and behavioral dysfunction, which carries high morbidity and mortality. Electroconvulsive therapy (ECT) is the definitive treatment for catatonia, but access to ECT for the treatment of catatonia remains inappropriately limited. Catatonia is observable, detectable, and relevant to various medical specialties, but underdiagnosis impedes the delivery of appropriate treatment and heightens risk of serious complications including iatrogenesis. Current understanding of catatonia’s pathophysiology links it to the current understanding of ECT’s mechanism of action. Definitive catatonia care requires recognition of the syndrome, workup to identify and treat the underlying cause, and effective management including appropriate referral for ECT. Even when all of these conditions are met, and despite well-established data on the safety and efficacy of ECT, stigma surrounding ECT and legal restrictions for its use in catatonia are additional critical barriers. Addressing the underdiagnosis of catatonia and barriers to its treatment with ECT is vital to improving outcomes for patients. While no standardized protocols for treatment of catatonia with ECT exist, a large body of research guides evidence-based care and reveals where additional research is warranted. The authors conducted a review of the literature on ECT as a treatment for catatonia. Based on the review, the authors offer strategies and future directions for improving access to ECT for patients with catatonia, and propose an algorithm for the treatment of catatonia with ECT.Keywords: catatonia, electroconvulsive therapy, underdiagnosis, algorithmLloyd JRSilverman ERKugler JLCooper JJDove Medical Pressarticlecatatoniaelectroconvulsive therapyunderdiagnosisalgorithmNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 2191-2208 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	catatonia electroconvulsive therapy underdiagnosis algorithm Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	catatonia electroconvulsive therapy underdiagnosis algorithm Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Lloyd JR Silverman ER Kugler JL Cooper JJ Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
description	Jenifer R Lloyd,1 Eric R Silverman,1 Joseph L Kugler,2 Joseph J Cooper1 1Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Psychiatry, University of Texas-Dell Medical School, Austin, TX, USACorrespondence: Jenifer R LloydDepartment of Psychiatry, University of Illinois at Chicago, 912 S Wood St (MC 913), Chicago, IL 60612, USATel +1 312-996-0906Fax +1 312-996-9517Email jlloyd5@uic.eduAbstract: Catatonia is a serious, common syndrome of motoric and behavioral dysfunction, which carries high morbidity and mortality. Electroconvulsive therapy (ECT) is the definitive treatment for catatonia, but access to ECT for the treatment of catatonia remains inappropriately limited. Catatonia is observable, detectable, and relevant to various medical specialties, but underdiagnosis impedes the delivery of appropriate treatment and heightens risk of serious complications including iatrogenesis. Current understanding of catatonia’s pathophysiology links it to the current understanding of ECT’s mechanism of action. Definitive catatonia care requires recognition of the syndrome, workup to identify and treat the underlying cause, and effective management including appropriate referral for ECT. Even when all of these conditions are met, and despite well-established data on the safety and efficacy of ECT, stigma surrounding ECT and legal restrictions for its use in catatonia are additional critical barriers. Addressing the underdiagnosis of catatonia and barriers to its treatment with ECT is vital to improving outcomes for patients. While no standardized protocols for treatment of catatonia with ECT exist, a large body of research guides evidence-based care and reveals where additional research is warranted. The authors conducted a review of the literature on ECT as a treatment for catatonia. Based on the review, the authors offer strategies and future directions for improving access to ECT for patients with catatonia, and propose an algorithm for the treatment of catatonia with ECT.Keywords: catatonia, electroconvulsive therapy, underdiagnosis, algorithm
format	article
author	Lloyd JR Silverman ER Kugler JL Cooper JJ
author_facet	Lloyd JR Silverman ER Kugler JL Cooper JJ
author_sort	Lloyd JR
title	Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
title_short	Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
title_full	Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
title_fullStr	Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
title_full_unstemmed	Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives
title_sort	electroconvulsive therapy for patients with catatonia: current perspectives
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/ce2ca1e4df724d6397e360581cf3bac2
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Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives

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