Periodic Catatonia: Long-term Treatment With Lamotrigine: A Case Report
Papageorgiou, Charalabos C. and
Periodic catatonia is a rare form of catatonia, characterized by
episodes occurring in a cyclic pattern with clinical features of
combined stupor and excitement, with intervals of remission. Although
periodic catatonia is not common, it is an urgent condition, requiring
hospitalization for evaluation and treatment. The management of periodic
catatonia is quite challenging, mainly because of the unknown
pathophysiological mechanisms involved in the onset of this clinical
entity, which are less clear than in other forms of catatonia. Although
positive trials of several medications in the acute phase of periodic
catatonia have been published, available literature concerning the
prevention of recurrent catatonic episodes is scarce. Here, we present
the case of a patient with periodic catatonia in which long-term
treatment with lamotrigine appears to have acted prophylactically in
reducing the occurrence and severity of new catatonic episodes. A better
understanding of the mechanisms involved in the pathophysiology of
periodic catatonia and increasing psychiatrists' and physicians'
awareness of the presentation of this clinical entity could be of
benefit in shedding light on the most appropriate treatment approach.
However, further clinical studies are needed before any firm
recommendations can be made.