Rosebush and Mazurek (2004) recommend that unless there is a contraindication to using the intramuscular route, such as a known bleeding condition, patients with catatonia should receive lorazepam 2 mg im initially. Response is typically seen within 1-3 hours. If there is no response after 3 hours, the same dosage should be repeated, and again a 3-hour period should be allowed to elapse. If, once again, there is no response, a third injection may be given. The young, elderly, or medically compromised should have the dose reduced to 1 mg each time.
Ref: - Rosebush, P.I. & Mazurek, M.F. (2004) Pharmacotherapy. In: Catatonia: from psychopathology to neurobiology, (Eds.) Caroff, S.N., Mann, S.C., Francis, A. & Fricchione, G.L. pp 141 – 150, Washington: American Psychiatric Publishing.
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This blog on Clinical Psychopharmacology is maintained by Dr. Shahul Ameen, M.D., Psychiatrist, St. John's Hospital, Kattappana, Idukki, Kerala, India.
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