A depressed adolescent who won’t eat and reacts slowly
Ms. A, age 13, faints after not eating or drinking for 3 days because she fears getting ‘bigger.’ She has poor recall, difficulty concentrating, and psychomotor retardation. How would you proceed?
Bottom Line
Catatonia in adolescents should be addressed early, when it is treatable and the outcome is favorable. It is important to recognize catatonia in an emergency department or inpatient medical unit setting in a hospital because it is often underdiagnosed or misdiagnosed. The presentation of catatonia is similar in adolescents and adults. Benzodiazepines are first-line treatment for catatonia; consider electroconvulsive therapy if patients do not respond to drug therapy.
Related Resources
• Roberto AJ, Pinnaka S, Mohan A, et al. Adolescent catatonia successfully treated with lorazepam and aripiprazole. Case Rep Psychiatry. 2014;2014:309517. doi: 10.1155/2014/309517.
• Raffin M, Zugaj-Bensaou L, Bodeau N, et al. Treatment use in a prospective naturalistic cohort of children and adolescents with catatonia. Eur Child Adolesc Psychiatry. 2015;24(4):441-449.
Drug Brand Names
Aripiprazole • Abilify Minocycline • Minocin
L-methylfolate • Deplin Olanzapine • Zyprexa
Lorazepam • Ativan Sertraline • Zoloft
Methylphenidate • Ritalin, Concerta Zolpidem • Ambien, Intermezzo
Disclosure
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
