Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology

Jonathan P Rogers; Mark A Oldham; Gregory Fricchione; Georg Northoff; Jo Ellen Wilson; Stephan C Mann; Andrew Francis; Angelika Wieck; Lee Elizabeth Wachtel; Glyn Lewis; Sandeep Grover; Dusan Hirjak; Niraj Ahuja; Michael S Zandi; Allan H Young; Kevin Fone; Simon Andrews; David Kessler; Tabish Saifee; Siobhan Gee; David S Baldwin; Anthony S David

doi:10.1177/02698811231158232

Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology

Jonathan P Rogers^*, Mark A Oldham, Gregory Fricchione, Georg Northoff, Jo Ellen Wilson, Stephan C Mann, Andrew Francis, Angelika Wieck, Lee Elizabeth Wachtel, Glyn Lewis, Sandeep Grover, Dusan Hirjak, Niraj Ahuja, Michael S Zandi, Allan H Young, Kevin Fone, Simon Andrews, David Kessler, Tabish Saifee, Siobhan GeeDavid S Baldwin, Anthony S David

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

40 Citations (Scopus)

255 Downloads (Pure)

Abstract

The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and were graded in terms of their strength. The guideline initially covers the diagnosis, aetiology, clinical features and descriptive epidemiology of catatonia. Clinical assessments, including history, physical examination and investigations are then considered. Treatment with benzodiazepines, electroconvulsive therapy and other pharmacological and neuromodulatory therapies is covered. Special regard is given to periodic catatonia, malignant catatonia, neuroleptic malignant syndrome and antipsychotic-induced catatonia. There is attention to the needs of particular groups, namely children and adolescents, older adults, women in the perinatal period, people with autism spectrum disorder and those with certain medical conditions. Clinical trials were uncommon, and the recommendations in this guideline are mainly informed by small observational studies, case series and case reports, which highlights the need for randomised controlled trials and prospective cohort studies in this area.

Original language	English
Pages (from-to)	327-369
Number of pages	43
Journal	Journal of Psychopharmacology
Volume	37
Issue number	4
DOIs	https://doi.org/10.1177/02698811231158232
Publication status	Published - 11 Apr 2023

Bibliographical note

Funding Information:
AH’s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Funding Information:
AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies.

Funding Information:
AY is the Editor of Journal of Psychopharmacology and Deputy Editor, BJPsych Open. He has given paid lectures and has been on advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Boehringer Ingelheim, Eli Lilly, LivaNova, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage, Novartis and Neurocentrx. He is the principal investigator on the Restore-Life VNS registry study (funded by LivaNova); ESKETINTRD3004: ‘An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression’, ‘The Effects of Psilocybin on Cognitive Function in Healthy Participants’ and ‘The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)’. He is the UK Chief Investigator for Compass: COMP006 & COMP007 studies and for Novartis MDD study MIJ821A12201. He has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies.

Funding Information:
The authors would like to thank Professor Thomas Barnes for his advice in preparing this guideline. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560. AH’s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560.

Publisher Copyright:
© The Author(s) 2023.

Keywords

Adolescent
Aged
Child
Female
Humans
Antipsychotic Agents/adverse effects
Autism Spectrum Disorder/drug therapy
Catatonia/diagnosis
Psychopharmacology

Access to Document

10.1177/02698811231158232Licence: CC BY

Full-text PDF (final published version)
This is the final published version of the article (version of record). It first appeared online via SAGE at https://journals.sagepub.com/doi/10.1177/02698811231158232. Please refer to any applicable terms of use of the publisher.
Final published version, 765 KBLicence: CC BY

Handle.net

Persistent link

Cite this

Rogers, J. P., Oldham, M. A., Fricchione, G., Northoff, G., Ellen Wilson, J., Mann, S. C., Francis, A., Wieck, A., Elizabeth Wachtel, L., Lewis, G., Grover, S., Hirjak, D., Ahuja, N., Zandi, M. S., Young, A. H., Fone, K., Andrews, S., Kessler, D., Saifee, T., ... David, A. S. (2023). Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 37(4), 327-369. https://doi.org/10.1177/02698811231158232

@article{49e5a12b28f64c1a8443d72fe52da4ee,

title = "Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology",

abstract = "The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and were graded in terms of their strength. The guideline initially covers the diagnosis, aetiology, clinical features and descriptive epidemiology of catatonia. Clinical assessments, including history, physical examination and investigations are then considered. Treatment with benzodiazepines, electroconvulsive therapy and other pharmacological and neuromodulatory therapies is covered. Special regard is given to periodic catatonia, malignant catatonia, neuroleptic malignant syndrome and antipsychotic-induced catatonia. There is attention to the needs of particular groups, namely children and adolescents, older adults, women in the perinatal period, people with autism spectrum disorder and those with certain medical conditions. Clinical trials were uncommon, and the recommendations in this guideline are mainly informed by small observational studies, case series and case reports, which highlights the need for randomised controlled trials and prospective cohort studies in this area.",

keywords = "Adolescent, Aged, Child, Female, Humans, Antipsychotic Agents/adverse effects, Autism Spectrum Disorder/drug therapy, Catatonia/diagnosis, Psychopharmacology",

author = "Rogers, {Jonathan P} and Oldham, {Mark A} and Gregory Fricchione and Georg Northoff and {Ellen Wilson}, Jo and Mann, {Stephan C} and Andrew Francis and Angelika Wieck and {Elizabeth Wachtel}, Lee and Glyn Lewis and Sandeep Grover and Dusan Hirjak and Niraj Ahuja and Zandi, {Michael S} and Young, {Allan H} and Kevin Fone and Simon Andrews and David Kessler and Tabish Saifee and Siobhan Gee and Baldwin, {David S} and David, {Anthony S}",

note = "Funding Information: AH{\textquoteright}s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Funding Information: AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: AY is the Editor of Journal of Psychopharmacology and Deputy Editor, BJPsych Open. He has given paid lectures and has been on advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Boehringer Ingelheim, Eli Lilly, LivaNova, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage, Novartis and Neurocentrx. He is the principal investigator on the Restore-Life VNS registry study (funded by LivaNova); ESKETINTRD3004: {\textquoteleft}An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression{\textquoteright}, {\textquoteleft}The Effects of Psilocybin on Cognitive Function in Healthy Participants{\textquoteright} and {\textquoteleft}The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD){\textquoteright}. He is the UK Chief Investigator for Compass: COMP006 & COMP007 studies and for Novartis MDD study MIJ821A12201. He has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: The authors would like to thank Professor Thomas Barnes for his advice in preparing this guideline. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560. AH{\textquoteright}s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560. Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

month = apr,

day = "11",

doi = "10.1177/02698811231158232",

language = "English",

volume = "37",

pages = "327--369",

journal = "Journal of Psychopharmacology",

issn = "0269-8811",

publisher = "SAGE Publications Ltd",

number = "4",

}

Rogers, JP, Oldham, MA, Fricchione, G, Northoff, G, Ellen Wilson, J, Mann, SC, Francis, A, Wieck, A, Elizabeth Wachtel, L, Lewis, G, Grover, S, Hirjak, D, Ahuja, N, Zandi, MS, Young, AH, Fone, K, Andrews, S, Kessler, D, Saifee, T, Gee, S, Baldwin, DS & David, AS 2023, 'Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology', Journal of Psychopharmacology, vol. 37, no. 4, pp. 327-369. https://doi.org/10.1177/02698811231158232

TY - JOUR

T1 - Evidence-based consensus guidelines for the management of catatonia

T2 - Recommendations from the British Association for Psychopharmacology

AU - Rogers, Jonathan P

AU - Oldham, Mark A

AU - Fricchione, Gregory

AU - Northoff, Georg

AU - Ellen Wilson, Jo

AU - Mann, Stephan C

AU - Francis, Andrew

AU - Wieck, Angelika

AU - Elizabeth Wachtel, Lee

AU - Lewis, Glyn

AU - Grover, Sandeep

AU - Hirjak, Dusan

AU - Ahuja, Niraj

AU - Zandi, Michael S

AU - Young, Allan H

AU - Fone, Kevin

AU - Andrews, Simon

AU - Kessler, David

AU - Saifee, Tabish

AU - Gee, Siobhan

AU - Baldwin, David S

AU - David, Anthony S

N1 - Funding Information: AH’s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Funding Information: AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: AY is the Editor of Journal of Psychopharmacology and Deputy Editor, BJPsych Open. He has given paid lectures and has been on advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Boehringer Ingelheim, Eli Lilly, LivaNova, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage, Novartis and Neurocentrx. He is the principal investigator on the Restore-Life VNS registry study (funded by LivaNova); ESKETINTRD3004: ‘An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression’, ‘The Effects of Psilocybin on Cognitive Function in Healthy Participants’ and ‘The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)’. He is the UK Chief Investigator for Compass: COMP006 & COMP007 studies and for Novartis MDD study MIJ821A12201. He has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: The authors would like to thank Professor Thomas Barnes for his advice in preparing this guideline. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560. AH’s independent research is funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AY has received grant funding (past and present) from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK); Janssen (UK), and EU Horizon 2020. He has no shareholdings in pharmaceutical companies. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: JPR is funded by the Wellcome Trust (220659/Z/20/Z). MSZ, GL and ASD are supported by the UK NIHR University College London Hospitals Biomedical Research Centre. MAO is supported by the National Institute on Aging of the National Institutes of Health (K23AG072383). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DH received support from the German Research Foundation (DFG, grant number DFG HI 1928/5-1 and HI 1928/6-1). JEW received support from the Veterans Affairs (VA) Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center, the VA Office for Rural Health and from the National Institutes of Health (NIH) MH070560. Publisher Copyright: © The Author(s) 2023.

PY - 2023/4/11

Y1 - 2023/4/11

N2 - The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and were graded in terms of their strength. The guideline initially covers the diagnosis, aetiology, clinical features and descriptive epidemiology of catatonia. Clinical assessments, including history, physical examination and investigations are then considered. Treatment with benzodiazepines, electroconvulsive therapy and other pharmacological and neuromodulatory therapies is covered. Special regard is given to periodic catatonia, malignant catatonia, neuroleptic malignant syndrome and antipsychotic-induced catatonia. There is attention to the needs of particular groups, namely children and adolescents, older adults, women in the perinatal period, people with autism spectrum disorder and those with certain medical conditions. Clinical trials were uncommon, and the recommendations in this guideline are mainly informed by small observational studies, case series and case reports, which highlights the need for randomised controlled trials and prospective cohort studies in this area.

AB - The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and were graded in terms of their strength. The guideline initially covers the diagnosis, aetiology, clinical features and descriptive epidemiology of catatonia. Clinical assessments, including history, physical examination and investigations are then considered. Treatment with benzodiazepines, electroconvulsive therapy and other pharmacological and neuromodulatory therapies is covered. Special regard is given to periodic catatonia, malignant catatonia, neuroleptic malignant syndrome and antipsychotic-induced catatonia. There is attention to the needs of particular groups, namely children and adolescents, older adults, women in the perinatal period, people with autism spectrum disorder and those with certain medical conditions. Clinical trials were uncommon, and the recommendations in this guideline are mainly informed by small observational studies, case series and case reports, which highlights the need for randomised controlled trials and prospective cohort studies in this area.

KW - Adolescent

KW - Aged

KW - Child

KW - Female

KW - Humans

KW - Antipsychotic Agents/adverse effects

KW - Autism Spectrum Disorder/drug therapy

KW - Catatonia/diagnosis

KW - Psychopharmacology

U2 - 10.1177/02698811231158232

DO - 10.1177/02698811231158232

M3 - Article (Academic Journal)

C2 - 37039129

SN - 0269-8811

VL - 37

SP - 327

EP - 369

JO - Journal of Psychopharmacology

JF - Journal of Psychopharmacology

IS - 4

ER -

Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology

Abstract

Bibliographical note

Keywords

Access to Document

Handle.net

Fingerprint

Cite this