Catatonia successfully treated with lorazepam and clozapine in an adolescent with first episode psychosis: A case report

Abstract

Catatonic syndrome is associated with changes in motor activity that can be primary or secondary to both psychiatric and non-psychiatric illnesses. This condition is less described in the pediatric population, for which early detection and management are of critical importance. Once identified, the treatment of catatonia in children is less elucidated and concern regarding high-dose of medications may lead to less aggressive treatment in this population. We report a case of catatonia in a 16-year-old male with first onset psychosis successfully managed with a combination of lorazepam and clozapine. We then reviewed the literature supporting the use of clozapine in the management of catatonia. This second-generation antipsychotic is particularly suited for treating catatonia because of its complex receptor interactions. We also highlight some challenges in identifying and managing catatonia in children with a focus on the importance of engaging effectively with the patient's family.