Lorazepam-Resistant Catatonia in an Antipsychotic-Naïve24-Year-Old with Psychotic Symptoms

Catatonia is a complex identifiable clinical syndrome characterized primarily by psychomotor symptoms. In recent decades, someauthors have considered that catatonia can be presented as a catatonic syndrome in several pathologies such as bipolar disorder,schizophrenia and other psychotic disorders and not only in schizophrenia. Prior to DSM 5, there were two conceptions ofcatatonia: one in which clinical characterization seemed to play a determining role (a categorical view) and another in which adimensional perspective advocated the existence of catatonia as a clinical entity in its own right, detached from the underlyingpathology. Although there are no definitive consensus guidelines for the treatment of catatonia, some studies show that inthe schizophrenic form of catatonia, benzodiazepines are partially effective, as well as treatment with ECT. We present the caseof a 24-year-old man with severe catatonia and psychotic symptoms, resistant to lorazepam treatment, who achieved completeremission with clozapine treatment according to our diagnostic hypothesis of schizophrenia.