Catatonia in Autistic Spectrum Disorders: A Medical Treatment Algorithm
Abstract
Autism is a developmental syndrome with an unknown biology and inadequate therapeutics. Assessing the elements of the syndrome for the presence of depression, psychosis, mania, or catatonia, offers opportunities for systematic intervention. Since almost all descriptions of autism highlight the presence of motor symptoms that characterize catatonia, an assessment for this eminently treatable syndrome is recommended for all patients considered to be autistic. A minimum examination includes a catatonia rating scale and for those patients with defined catatonia, a lorazepam test. For those whose catatonia responds to lorazepam, high dose lorazepam therapy is recommended. If this fails, electroconvulsive therapy is recommended. The assessment and treatment of catatonia offers positive medical therapy for the victims of autism and their families.
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Benzodiazepine use in autism is relatively uncommon due to concerns of behavioral disinhibition; some anticonvulsants likely exert GABAergic effects and are used for mood stabilization; there is ongoing interest in GABAergic treatments for catatonia in autism.
“While benzodiazepine use in autism is relatively uncommon, owing to concerns of behavioral disinhibition, some anticonvulsants that likely exert GABAergic effects are used for mood stabilization [262], and there is ongoing interest in the potential role of GABAergic treatments for catatonia in autism [263].”
From Consensus Paper: Pathological Role of the Cerebellum in Autism (2012) · cites this paper as [263]
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Dunstall, H. M., Walton, C., Watkins, L. V., Isaac, A. B., & Tahir, M. O. E. (2019) · Advances in Mental Health and Intellectual Disabilities · doi:10.1108/amhid-07-2018-0034 · Cited by 1 · see citing works
Section I – The efficacy and safety of electroconvulsive therapy
Maixner, D. F., & Taylor, M. A. (2008) · Cambridge University Press eBooks · doi:10.1017/cbo9780511544392.005
Self-citationDhossche, D. M., & Wachtel, L. E. (2008)
ECT in People with an Intellectual Disability
Cutajar, P., & Jones, J. (2019) · Cambridge University Press eBooks · doi:10.1017/9781911623175.007
Catatonia: A Rare Manifestation of Autism
Al-Mosawi, A. J. (2022) · International Journal of Genetics and Genomic Science · doi:10.58489/2836-2306/005
Catatonia: A Rare Manifestation of Autism
Al-Mosawi, A. J. (2022) · MedPress Psychiatry and Behavioral Sciences · doi:10.33582/mppbs.2022.202209008
Catatonia, Neuroleptic Malignant Syndrome, and Serotonin Syndrome
Praschan, N. C., Beach, S. R., Fricchione, G. L., Huffman, J. C., & Stern, T. A. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-11844-9.00038-2
Davani, A. J., Richardson, A. J. W., Vodovozov, W., & Sanghani, S. N. (2024) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2024.05.013
Abdole, L., Reynard, H. L., Ince, H. Y., Palffy, A. W., Jackson, J., & Ghaziuddin, N. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1782341
Self-citation
- Authors
- Fink, M., Taylor, M. A., & Ghaziuddin, N.
- Affiliations
- Stony Brook University (US)
- Rosalind Franklin University of Medicine and Science (US)
- University of Michigan (US)
- Venue
- International Review of Neurobiology
- Publisher
- Elsevier
- Published
- 2006
- Volume
- 72
- Pages
- 233-244
- ISSN
- 0074-7742 (ISSN-L)
- OpenAlex
- W1529072181
- Cited by
- 83
- References
- 35
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 10 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 1 · 2014: 4 · 2013: 2 · 2012: 8
- FWCI
- 25.14
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- International review of neurobiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- catatonia, autism spectrum disorder, electroconvulsive therapy, treatment algorithm, motor symptoms, depression, psychosis, mania
- MeSH terms
- Adolescent, Algorithms, Anticonvulsants, Autistic Disorder, Catatonia, Electroconvulsive Therapy, Female, Humans, Lorazepam, Male
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