Some people who have schizophrenia or other serious mental illnesses develop catatonia, which consists of extreme lack of movement or constant repetitive movement over which they seem to have very little control. Whilst in a catatonic state these people are unable to interact with their environment and may go on to acquire secondary problems such as pneumonia, blood clotting problems (thrombosis), malnutrition or dehydration. Current treatments for this are either drugs, which are given by injection, or electric shock treatment (electroconvulsive therapy). The aim of this review is to look at how effective benzodiazepines are compared to placebo or other drug treatments in treating this problem. However, while some clinical trials that seemed relevant were identified, no usable data could be extracted from them. There is no good trial-derived data on this subject. However, there are five trials on which more information needs to be collected. In the longer term, to make sure people with catatonia receive the most effective treatment, this is an area that would benefit from good research and well planned and reported trials. Also, since the condition is rare, there should be good communication between those involved in researching it.
(Plain language summary prepared for this review by Janey Antoniou of RETHINK, UK www.rethink.org)
Studies have been justified and undertaken in the past. This justification remains as relevant as ever. Further studies with a high-quality methodology and reporting are required and it may be for countries where catatonia is seen often to take a lead in this area.
Catatonia is a debilitating disorder of movement and volition associated with schizophrenia and some other mental disorders. People in a catatonic state have increased risk of secondary complications such as pneumonia, malnutrition and dehydration. The mainstay of treatment has been drug therapies and electroconvulsive therapy.
To compare the effects of benzodiazepines with other drugs, placebo or electroconvulsive therapy for people with catatonia.
We searched the Cochrane Schizophrenia Group Trials Register (March 2007) and manually searched reference lists from the selected studies.
All relevant randomised controlled clinical trials.
We (RCG, GW) extracted data independently. For dichotomous data we would have calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis using a fixed-effect model.
No studies could be included. We did find studies reporting no usable data that we had to exclude or assign to those awaiting assessment. These studies, although poorly reported, do illustrate that relevant studies have been undertaken, and are not impossible.