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Table 1 Clinical presentation of catatonic symptoms

From: Periodic catatonia with long-term treatment: a case report

Episode

Admission date

age

Catatonic symptoms

Positive symptoms

Medications

Lorazepam-diazepam protocol

1

2001/8/31

35

Stupor, negativism, mutism

AH

Risperidone 4 mg/day

Diazepam IVD 10 mg diluted in 500 ml Normal saline for 3 days

2

2002/12/16

36

Stupor, negativism, mutism

AH, Capras syndrome

Haloperidol 15 mg/day

➪ Olanzapine 15 mg/day

Lorazepam 3 mg/day

Diazepam IVD for 2 days

3

2003/9/24

37

Stupor,catalepsy, mutism

AH

Loxapine 150 mg/day

Lorazepam 2 mg/day

Lorazepam 2 mg IM follow by another dose of Lorazepam 2 h later

2003/ 10/11

mutism, stupor

AH

Lorazepam 2 mg IM for three dosage with interval of 2 h

4

2004/2/6

38

Stupor, catalepsy, mutism

AH, Bizarre behavior, Capras syndrome

Quetiapine 550 mg/day

Diazepam 2 mg/day

Not administered

5

2006/2/3

40

Stupor, mutism, catalepsy

VH, AH, delusion of being controlled, bizarre delusion

Clozapine 200 mg/day

Lorazepam 2 mg/day

Lorazepam 2 mg IM for three dosage with interval of 2 h

6

2006/9/25

40

Stupor, negativism, mutism

AH, persecutory delusion, self harm behavior

Clozapine 200 mg/day

Lorazepam 2 mg/day

Lorazepam 2 mg IM follow by another dose of Lorazepam 2 h later, follow by diazepam 10 mg diluted in N/S 500 ml for 3 days

7

2015/11/23

49

Stupor, mutism, agitation for 2 h, recurrent 6 h later

AH, persecutory delusion

Clozapine 300 mg/day

Lorazepam 3 mg/day

Lorazepam 2 mg IM for three dosage with interval of 2 h

  1. Abbreviation: AH auditory hallucination, VH visual hallucination, IVD Intravenous dripping, IM intramuscular, N/S normal saline