Effectiveness of Intramuscular Aripiprazole Injection in Patients with Catatonia: Report on Three Cases

In the recent literature, orally administered aripiprazole, a second generation antipsychotic, was demonstrated to be effective in the resolution of catatonia. Our present paper is the first report of three cases of catatonia where intramuscularly administered high doses of aripiprazole were found to be effective in resolving severe catatonic states, independent of the features, or of the origin of catatonia, presenting either in schizophrenia or in major depression. On the basis of the unique mechanism of action of the drug and based on our clinical experience, we recommend the use of high doses of intramuscular aripiprazole as an alternative treatment for catatonia, when benzodiazepines or electroconvulsive therapy are not effective or not proposed.

References

• 1 American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Press Inc. 2000
• 2 Bastiampillai T, Dhillon R. Catatonia resolution and aripiprazole.  Austral New Zeal J Psychiatry. 2008;  12 907
• 3 Bush G, Fink M, Petrides G. et al . Rating scale and standardized examination.  Acta Psychiatr Scand. 1996;  93 9-136
• 4 Caroff SN, Mann SC, Francis A. et al .eds Catatonia: From psychopathology to neurobiology. American Psychiatric Publishing Inc. 2004
• 5 Fink M, Taylor MA. eds Catatonia: A clinician's guide to diagnosis and treatment. Cambridge (UK): Cambridge University Press 2003
• 6 Freeman B, Levy W, Gorman JM. Successful monotherapy treatment with aripiprazole in a patient with schizophrenia and prolactinoma.  J Psychiatr Pract. 2007;  13 120-124
• 7 Huffman J, Fricchione G. Catatonia and psychosis in a patient with AIDS: treatment with lorazepam and aripiprazole.  J Clin Psychopharmacol. 2006;  25 508-510
• 8 Hung GC, Chen YY. Extrapyramidal side effects associated with aripiprazole administration in a schizophrenic patient.  Pharmacopsychiatry. 2007;  40 83-84
• 9 Northoff G. Catatonia and neuroleptic malignant syndrome: psychopathology and pathophysiology.  J Neural Transm. 2002;  109 1453-1467
• 10 Philbrick KL, Rummans TA. Malignant catatonia.  J Neuropsychiatry Clin Neurosci. 1999;  6 1-13
• 11 Sheldrick AJ, Gründer G. Aripiprazole reduces serum prolactin in a woman with prolactinoma and acute psychosis.  Pharmacopsychiatry. 2008;  41 160
• 12 Strawn JR, Delgado SV. Successful treatment of catatonia with aripiprazole in an adolescent with psychosis.  J Child Adolesc Psychopharmacol. 2007;  17 733-735
• 13 Van Den Eede F, Van Hecke J, Van Dalfsen A. et al . The use of atypical antipsychotics in the treatment of catatonia.  Eur Psychiatry. 2005;  20 422-429
• 14 World Health Organization . The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva (Switzerland): World Health Organization 1992

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