Gaind G S, Rosebush P I, Mazurek M F
Department of Psychiatry, McMaster University Medical Centre, Hamilton, Ontario, Canada.
J Clin Psychiatry. 1994 Jan;55(1):20-3.
Acute catatonia of the retarded type responds rapidly to treatment with lorazepam. There is little information about (1) the efficacy of benzodiazepines in patients with longstanding catatonic syndrome; (2) the effect of longer-term lorazepam therapy in catatonic patients who do not respond to a brief trial of the medication; and (3) the development of catatonic syndromes in family members.
We gave lorazepam to two mentally retarded brothers with catatonia. One had become catatonic 2 weeks before starting treatment while the other had been hospitalized in a catatonic state for 5 years.
The brother with acute catatonia recovered slowly but completely within 2 weeks of starting lorazepam. The brother with long-standing catatonia responded gradually during the first 5 months of treatment and required higher doses of lorazepam but did eventually recover and was discharged from the hospital on a regimen of lorazepam after 1 year of treatment.
(1) Lorazepam may be effective even in patients who have been catatonic for years. (2) Catatonic patients who do not recover immediately with lorazepam may respond to a longer course or higher doses of the medication. (3) There may be a familial predisposition to developing catatonia in response to stressful situations.
迟滞型急性紧张症对劳拉西泮治疗反应迅速。关于以下方面的信息较少：（1）苯二氮䓬类药物对长期紧张症综合征患者的疗效；（2）对劳拉西泮短期试用无反应的紧张症患者进行长期劳拉西泮治疗的效果；（3）家庭成员中紧张症综合征的发生情况。
我们给两名患有紧张症的智障兄弟使用了劳拉西泮。其中一人在开始治疗前2周出现紧张症，另一人处于紧张症状态已住院5年。
患有急性紧张症的兄弟在开始使用劳拉西泮后的2周内恢复缓慢但完全康复。患有长期紧张症的兄弟在治疗的前5个月逐渐有反应，需要更高剂量的劳拉西泮，但最终康复，在治疗1年后以劳拉西泮方案出院。
（1）即使是患有多年紧张症的患者，劳拉西泮也可能有效。（2）对劳拉西泮不能立即康复的紧张症患者，可能对更长疗程或更高剂量的该药物有反应。（3）在应对压力情况时，可能存在发生紧张症的家族易感性。
