CATATONIA - SHORT-TERM RESPONSE TO LORAZEPAM AND DOPAMINERGIC METABOLISM

Therapeutic response to lorazepam and dopaminergic metabolism were inv estigated in 18 neuroleptically naive acute catatonic patients. They w ere diagnosed as catatonic according to criteria by Lohr and Rosebush and treated exclusively with lorazepam (2-4 mg) during the first 24 h. Dopaminergic metabolism (plasma HVA, plasma MHPG), anxiety (HAMA) and parkinsonic/dyskinetic movements (SEPS, AIMS) were measured under sta ndard conditions before initial treatment with lorazepam (day 0) and 2 4 h after initial treatment (day 1). On day 0 responders to lorazepam treatment (complete remission of catatonic syndrome after 24 h accordi ng to Rosebush and Lohr) showed significantly higher (P = 0.004) plasm a HVA (130.4 +/- 51.2 pmol/ml; means +/- SD) than non-responders (no r emission of catatonic syndrome after 23 h; 73.2 +/- 40.5 pmol/ml; mean s +/- SD). On day 1 plasma HVA did not differ any more significantly b etween both groups Clinically, responders showed significantly higher HAM-A (P = 0.025) and AIMS (P = 0.022) scores as well as significantly lower SEPS (P = 0.049) scores than non-responders on day 0. Hence cat atonic short-term responders and nonresponders to lorazepam can be dis tinguished with regard to plasma HVA, anxiety and dyskinetic/parkinson ic movements.