THE TREATMENT OF STUPOR ASSOCIATED WITH MRI EVIDENCE OF CEREBROVASCULAR-DISEASE

Objective. To describe the treatment and outcome of organic stupor ass ociated with MRI evidence of cerebrovascular disease, Design. A case s eries of three patients. Setting. An urban mental health of the elderl y service in southeast London. Patients. Aged 69 years, 72 years and 7 8 years. Two had organic catatonic disorder and the third organic depr essive disorder. Interventions. Diazepam, carbamazepine, antidepressan ts or electroconvulsive therapy (ECT). Main outcome measures. Resoluti on of symptoms and discharge from hospital. Results. Symptoms resolved between 1 and 10 days. All patients were able to return home but rela psed over the following 12 months. One relapse occurred when a patient stopped diazepam and moclobemide. Conclusions. It is proposed that th e initial treatment of organic stupor associated with cerebrovascular disease should include a benzodiazepine or carbamazepine. If patients fail to respond then ECT should be considered. The safety of ECT is no t known, when treating patients with depressive disorder associated wi th cerebrovascular disease. (C) 1997 John Wiley & Sons, Ltd.