Augmentative Asenapine in a Recurrent Manic Catatonic Patient with Partial Response to Clozapine

Massimiliano Buoli,Laura Cremaschi,Alice Caldiroli,A Carlo Altamura,Cristina Dobrea

doi:10.1155/2013/503601

Massimiliano Buoli, Laura Cremaschi + Show 3 more

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https://doi.org/10.1155/2013/503601

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Abstract

Catatonia is a severe but treatable neuropsychiatric syndrome known since the middle of the nineteenth century. It has been considered for a long time as a subtype of schizophrenia, even though this association occurs only in 10% of cases. In contrast, it is frequently observed in bipolar patients. First-line treatment consists of benzodiazepines, while in case of resistance electroconvulsive therapy (ECT) and clozapine have shown positive results. In addition, recent studies reported the efficacy of some atypical antipsychotics. The present case shows the clinical response to augmentative asenapine in a catatonic manic patient with a partial response to clozapine.

Highlights

The term Catatonia, coined in 1874 by Karl Kahlbaum, is a severe psychomotor syndrome characterized by the presence for more than 24 hours of at least two among a list of symptoms including stupor/immobility, rigidity, excessive motor activity, staring, posturing, and autonomic alterations
Even though catatonia has been considered for a long time a subtype of schizophrenia, this syndrome frequently occurs over other conditions including mood disorders [1, 2]
In this paper we report the case of a bipolar catatonic patient who showed response to augmentative asenapine after partial response to clozapine

Summary

Introduction

The term Catatonia, coined in 1874 by Karl Kahlbaum, is a severe psychomotor syndrome characterized by the presence for more than 24 hours of at least two among a list of symptoms including stupor/immobility, rigidity, excessive motor activity (purposeless), staring, posturing, and autonomic alterations. Even though catatonia has been considered for a long time a subtype of schizophrenia, this syndrome frequently occurs over other conditions including mood disorders [1, 2]. High dosages of benzodiazepines are the first-line treatment for catatonia; Electroconvulsive Therapy (ECT) is to be taken into consideration when patients do not respond to benzodiazepines or rapid resolution is necessary [3]. In this paper we report the case of a bipolar catatonic patient who showed response to augmentative asenapine after partial response to clozapine

Case Presentation

Findings

Discussion