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Psychosomatics 2019 Mar 4. Epub 2019 Mar 4.

Department of Psychiatry, Indiana University, Indianapolis, IN; Indiana University Health University Hospital, Indianapolis, IN.

Rev Colomb Psiquiatr 2019 Apr - Jun;48(2):127-130. Epub 2017 Dec 11.

Unidad de Neurología, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México.

Anti-N-methyl-D-Aspartate receptor (NMDAr) encephalitis is a recently described clinical entity with an increasing number of reported cases. Psychiatric symptoms in the early stages of the disease constitute a diagnostic challenge for the treating physician. We present two clinical cases: clinical case 1, a 26-year-old man, and clinical case 2, an 18-year-old man; both presented with a first episode of psychosis and were hospitalized as psychiatric disorders. Read More

Psychiatr Danub 2019 Mar;31(1):62-68

Psychiatric Hospital, Havlickuv Brod, Czech Republic.

Background: The aim of our retrospective naturalistic observational study was to describe the use of maintenance electroconvulsive therapy (M-ECT) in chronic pharmacoresistant schizophrenia.

Subjects And Methods: We delineated 19 cases of chronic pharmacoresistant schizophrenia (females N=12) recently treated with maintenance electroconvulsive therapy at the Havlickuv Brod Psychiatric Hospital in the Czech Republic. Demographic, clinical and treatment variables were recorded. Read More

J Pediatr Neurosci 2018 Oct-Dec;13(4):423-428

Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Introduction: A neuropsychiatric syndrome characterized by a wide spectrum of clinical manifestations. It is seen in patients with antibodies against NR1-NR2 heteromers of the NMDA receptor. As the spectrum is mainly psychiatric most patients are treated as psychiatric disease resulting in huge diagnostic delay. Read More

Bioorg Chem 2019 Mar 19;87:601-612. Epub 2019 Mar 19.

Institut für Pharmakologie und Toxikologie, Universität Würzburg, Germany.

In the present study, an attempt has been made to develop a new series of 1,3,7,8-tetrasubstituted xanthine based potent and selective AR ligands for the treatment of Parkinson's disease. Antagonistic interactions between dopamine and A adenosine receptors serve as the basis for the development of AR antagonists as potential drug candidates for PD. All the synthesized compounds have been evaluated for their affinity toward AR subtypes using in vitro radioligand binding assays. Read More

BJR Case Rep 2018 Dec 30;4(4):20180030. Epub 2018 Jun 30.

Department of Neuroscience, Faculty of Medicine, Anglia Ruskin University, Chelmsford, Essex, , UK.

Despite some differences in clinical presentation, it is often difficult to differentiate between dementia with Lewy bodies (DLB), clinical Alzheimer's dementia (AD) and Parkinson's disease dementia. However, differentiation can be crucial, especially as patients with DLB characteristically have a hypersensitivity to most antiemetic and neuroleptic drugs as they affect the cholinergic and dopaminergic system, potentially leading to life-threatening catatonia, loss of cognitive function and muscle rigidity. The aim of this study is to evaluate if resting state (RS) functional MRI (fMRI) can be used in routine practice on a 1. Read More

J Dev Behav Pediatr 2019 Mar 26. Epub 2019 Mar 26.

Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA.

Case: Thomas is a 12-year-old boy with autism spectrum disorder who presents to his primary care clinician with symptoms of worsening mood in the last 3 months. On review of his last school testing, his cognitive abilities are found to be within the average range, with a relative vulnerability with his processing speed. He can speak in sentences to communicate and answer questions, but he rarely picks up on conversational bids. Read More

J Dev Behav Pediatr 2019 Apr;40(3):237-238

Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA.

Case: Thomas is a 12-year-old boy with autism spectrum disorder who presents to his primary care clinician with symptoms of worsening mood in the last 3 months. On review of his last school testing, his cognitive abilities are found to be within the average range, with a relative vulnerability with his processing speed. He can speak in sentences to communicate and answer questions, but he rarely picks up on conversational bids. Read More

Front Psychiatry 2019 27;10:86. Epub 2019 Feb 27.

Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.

Catatonia is a syndrome comprising psychomotor, behavioral, and autonomous symptoms which may occur in the context of severe schizophrenic, affective, and other mental disorders or medical conditions. Treatment options include high dose benzodiazepines (lorazepam) and electroconvulsive therapy (ECT) with some evidence for the effectiveness of glutamate antagonists. However, due to a lack of randomized controlled studies in this severely ill population, evidence base is weak. Read More

CNS Spectr 2019 Feb;24(1):217

Study Objective(s)Catatonia is not only present in adults; children & adolescents can suffer from catatonia but are often misdiagnosed. A study by Ghaziuddin, Dhossche and Marcotte (2012) found that 18 of the 101 child and adolescent patients had symptoms of catatonia, but only 2 actually had been given a diagnosis by their providers.

Method: 17-year-old male who was recently discharged from the inpatient psychiatric unit with the diagnosis of Major Depressive Disorder. Read More

BMJ Case Rep 2019 Mar 4;12(3). Epub 2019 Mar 4.

Academic Center for ECT and Neuromodulation (AcCENT), Universitair Psychiatrisch Centrum KU Leuven, Kortenberg, Belgium.

The objective of this article is to describe the possible association of catatonia and temporal brain lesions. This is a case presentation of a 57-year-old man presenting with depression, with catatonia secondary to a temporal glioblastoma. He was referred to hospital because for a sudden deterioration in depressed state. Read More

Asian J Psychiatr 2019 Mar 22;41:5-12. Epub 2019 Feb 22.

Associate Professor of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru - 560029, Karnataka, India. Electronic address:

Patients with progressive cognitive decline mostly suffer from degenerative disease and carry a relatively poor prognosis. But small groups among these patients have a potentially treatable cause of illness and therefore every patient with dementia needs to be considered treatable unless proved otherwise. This group can be identified only by high degree of suspicion based on clinical clues. Read More

Am J Med 2019 Mar 2. Epub 2019 Mar 2.

Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Geriatric Research, Education and Clinical Center, VA Tennessee Valley, Nashville, Tenn.

J Obstet Gynaecol Res 2019 Apr 20;45(4):935-937. Epub 2019 Feb 20.

Department of Neurology, Izmir Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.

Following a generalized tonic-clonic seizure, a previously healthy 27-year-old pregnant woman (18-week pregnancy) was admitted to our emergency department. She experienced lethargy, forgetfulness and persecutory hallucinations the day before hospitalization. Cerebrospinal fluid examination revealed moderate pleocytosis, and abdominal ultrasonography did not detect neoplasia. Read More

BMC Psychiatry 2019 Feb 19;19(1):73. Epub 2019 Feb 19.

Psychopharmacology Unit, Clinical pharmacology and toxicology division, Acute Medicine Department, Geneva University Hospital, Geneva, Switzerland.

Background: Rebound cholinergic syndrome is a rare, but well known unwanted phenomenon occurring after abrupt clozapine discontinuation. There have been previous reported cases of cholinergic rebound in the literature; however, these reports described cholinergic rebound following cessation of high doses of clozapine in patients diagnosed with schizophrenia. Here, we report a case of rebound cholinergic syndrome and catatonia in a male patient three days after abrupt discontinuation of 50 mg of clozapine prescribed for type I bipolar affective disorder. Read More

Pediatr Rheumatol Online J 2019 Feb 18;17(1). Epub 2019 Feb 18.

Section of Pediatric Rheumatology, Department of Pediatrics, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 5044, Chicago, 60637, IL, USA.

Background: Anti-NMDA receptor encephalitis, an autoimmune disease associated with antibodies against N-methyl-D-aspartate (NMDA) receptors, is being diagnosed more frequently, especially in children and young adults. Acute neurological and psychiatric manifestations are the common presenting symptoms. Diagnosing anti-NMDA receptor encephalitis is often challenging given the wide range of clinical presentation, and may be further complicated by its overlap of symptoms, brain MRI changes, and CSF findings with other entities affecting the brain. Read More

Stress 2019 Feb 15:1-9. Epub 2019 Feb 15.

b Psychiatric Centre Copenhagen, Department O, Rigshospitalet , Copenhagen University Hospital ,  Copenhagen , Denmark.

In this review it is discussed if acute stress can be fatal. The review is based on literature searches on PubMed, PsycINFO as well as Web of Science. Literature concerning the conditions excited delirium syndrome (ExDS), malignant catatonia, takotsubo cardiomyopathy (TCM), and capture myopathy (CM) is reviewed and compared. Read More

Lancet Psychiatry 2019 03 11;6(3):235-246. Epub 2019 Feb 11.

Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address:

Background: Early immunotherapy administration improves outcomes in patients with N-methyl-D-aspartate receptor (NMDAR)-antibody encephalitis. As most patients with NMDAR-antibody encephalitis present to psychiatrists, the psychopathology of NMDAR-antibody encephalitis needs to be clearly defined to encourage accurate clinical identification and prompt treatment.

Methods: For this systematic review, we searched PubMed for all studies published in English between Jan 1, 2005, and Oct 7, 2017, to identify individually reported adult patients (≥18 years) who satisfied consensus criteria for definite NMDAR-antibody encephalitis. Read More

Clin Neuropharmacol 2019 Mar/Apr;42(2):57-59

Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA.

Objective: Catatonia is a distinct psychomotor syndrome that involves a constellation of up to 40 different symptoms. Although conventionally responsive to benzodiazepines, the catatonic syndrome is much more resistant to benzodiazepine treatment when a feature of schizophrenia.

Method: We present a patient with schizophrenia with catatonic symptoms, marginally responsive to lorazepam challenge, lorazepam, and olanzapine monotherapy, but ultimately began combination treatment with these 2 medications. Read More

Eur J Case Rep Intern Med 2018 26;5(6):000855. Epub 2018 Jun 26.

Consultant in Internal Medicine - Beatriz Ângelo Hospital, Loures, Portugal.

Primary Sjögren's syndrome (SS) is a chronic, systemic autoimmune disease, most commonly presenting with sicca symptoms-xerostomia and xerophthalmia. Up to one-half of affected individuals also develop extra-glandular involvement. Early diagnosis is important to prevent further complications. Read More

Schizophr Bull 2019 Feb 7. Epub 2019 Feb 7.

Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.

Catatonia is a central aspect of schizophrenia spectrum disorders (SSD) and most likely associated with abnormalities in affective, motor, and sensorimotor brain regions. However, contributions of different cortical features to the pathophysiology of catatonia in SSD are poorly understood. Here, T1-weighted structural magnetic resonance imaging data at 3 T were obtained from 56 right-handed patients with SSD. Read More

Klin Mikrobiol Infekc Lek 2018 Jun;24(2):57-64

Department of Inectious Diseases, 3rd Medical faculty, Charles University, Prague, Hospital na Bulovce, Czech Republic, e-mail:

We present a case of a 17-year-old female with anti-NMDAR encephalitis probably associated with vaccination against yellow fever. Her symptoms occurred 27 days after vaccination against yellow fever. Anti-NMDAR encephalitis manifested as acute psychosis, memory loss and catatonia following fever with complex partial epileptic seizures. Read More

Semin Neurol 2019 Feb 11;39(1):125-136. Epub 2019 Feb 11.

Movement Disorders Division, Department of Neurology, Johns Hopkins, Baltimore, Maryland.

Many acute and potentially life-threatening medical conditions have hyperkinetic or hypokinetic movement disorders as their hallmark. Here we review the clinical phenomenology, and diagnostic principles of neuroleptic malignant syndrome, malignant catatonia, serotonin syndrome, Parkinsonism hyperpyrexia, acute parkinsonism, acute chorea-ballism, drug-induced dystonia, and status dystonicus. In the absence of definitive lab tests and imaging, only a high index of clinical suspicion, awareness of at-risk populations, and variations in clinical presentation can help with diagnosis. Read More

J ECT 2019 Feb 1. Epub 2019 Feb 1.

Department of Psychiatry University of Illinois at Chicago Chicago, Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, IL.

Brain Sci 2019 Feb 2;9(2). Epub 2019 Feb 2.

Department of Psychiatry, Griffin Memorial Hospital, Norman, OK 73071, USA.

Catatonia is often a presentation of extreme anxiety and depression. Missing the diagnosis of catatonia would lead to improper treatment, which could be life-threatening. A thorough physical and psychiatric assessment is required for detecting the catatonic symptoms, especially, mutism and negativism in patients with depression. Read More

IBRO Rep 2019 Jun 14;6:40-44. Epub 2018 Dec 14.

Department of Pharmacology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad university, Tehran, Iran.

Parkinson's disease is a progressive debilitative neurodegenerative disease characterised mostly with bradykinesia, tremor, catatonia, drooping posture, unsteady gate and unstable steps. Levodopa has been proven to be among the most effective and acceptable treatment that can reconstitute dopamine in Parkinson's disease. However, there is a relation between levodopa long term administration and dyskinesia. Read More

World J Psychiatry 2019 Jan 4;9(1):1-6. Epub 2019 Jan 4.

University of Notre Dame, Fremantle, WA 6009, Australia.

Electroconvulsive therapy (ECT), which is among the oldest and most controversial treatments in the field of psychiatry, has its 80 birthday this year. In this brief historical overview, the discovery of the therapeutic effects of convulsive therapy by Laszló Meduna, and the circumstances that motivated Ugo Cerletti and Lucio Bini to use electricity as a means of seizure induction are described. Meduna's original theory about the antagonism between epilepsy and schizophrenia has been replaced by hypotheses on the mechanism of action of ECT. Read More

Psychogeriatrics 2019 Jan 7. Epub 2019 Jan 7.

Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.

Nervenarzt 2019 Jan 7. Epub 2019 Jan 7.

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock, Gehlsheimer Straße 20, 18147, Rostock, Deutschland.

In the history of psychiatry a variety of "blood detoxification" procedures have repeatedly been used to treat schizophrenic disorders under the assumption of autointoxication. In the 1970s this led to the use of dialysis. In addition to the historical classification of this therapeutic approach, particularly the protagonists active in the German Democratic Republic (GDR) as well as the dimension of research and science policy are highlighted. Read More

Fed Regist 2018 12;83(246):66103-24

The Food and Drug Administration (FDA) is issuing a final order to reclassify the electroconvulsive therapy (ECT) device for use in treating catatonia or a severe major depressive episode (MDE) associated with major depressive disorder (MDD) or bipolar disorder (BPD) in patients age 13 years and older who are treatment-resistant or who require a rapid response due to the severity of their psychiatric or medical condition, which is a preamendments class III device, into class II (special controls). FDA is also issuing this final order to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for the preamendments class III ECT devices for all other uses that are not being reclassified to class II (product code GXC). Read More

Psychosomatics 2018 Dec 12. Epub 2018 Dec 12.

Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

BMJ Case Rep 2018 Dec 14;11(1). Epub 2018 Dec 14.

Internal Medicine, University of Miami/JFK Medical Center Palm Beach Regional GME Consortium, Atlantis, Florida, USA.

A 50-year-old man with multiple psychiatric comorbidities including major depressive disorder and general anxiety disorder presented to the emergency room (ER) with altered mental status, immobility and mutism. The patient was unresponsive to commands and unable to provide any history. In the ER he was given a provisional diagnosis of cerebrovascular accident (CVA). Read More

Cureus 2018 Oct 16;10(10):e3460. Epub 2018 Oct 16.

Psychiatry, Vancouver General Hospital, University of British Columbia, Vancouver, CAN.

Moyamoya disease (MMD) is a rare idiopathic cerebrovascular disease most common among the Asian population. Studies have shown that patients with MMD are at increased risk for developing psychiatric complications. We present a patient with hemorrhagic MMD (RNF213 gene mutation) who developed depression and catatonia over time following MMD-related strokes. Read More

J Neuropsychiatry Clin Neurosci 2018 Dec 18:appineuropsych18010005. Epub 2018 Dec 18.

From the Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston (Sarkis); the Menninger Clinic and Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Tex. (Coffey); the Department of Psychiatry, University of Illinois at Chicago (Cooper); the British Columbia Neuropsychiatry Program and Vancouver General Hospital Epilepsy Program, University of British Columbia (Hassan); and the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Lennox).

Objective:: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterized by prominent neuropsychiatric symptoms. Given the nature of its pathophysiology, psychiatrists tend to be one of the first clinicians encountering patients with the disease.

Methods:: In the present review of patients described in the literature with psychiatric symptoms, the authors aimed to characterize the psychiatric symptoms of the disease and its management in adults and adolescents as well as children (≤12 years old). Read More

Prim Care Companion CNS Disord 2018 Dec 13;20(6). Epub 2018 Dec 13.

Department of Psychiatry, Henry Ford Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, USA.

Dev Med Child Neurol 2018 Dec 12. Epub 2018 Dec 12.

Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.

Down syndrome disintegrative disorder (DSDD) is an increasingly identified condition characterized by cognitive decline, autistic characteristics, insomnia, catatonia, and psychosis in adolescents and young adults with Down syndrome. Previously we reported a higher rate of autoimmune thyroid disease in these patients compared with unaffected individuals with Down syndrome. We therefore hypothesized DSDD may in some cases be immune-mediated. Read More

J Med Vasc 2018 Dec 1;43(6):371-374. Epub 2018 Nov 1.

Service de médecine vasculaire, CHU Amiens-Picardie, Site Sud, 80054 Amiens cedex 1, France.

Catatonia is defined as a psychiatric syndrome. This syndrome is strongly associated with venous thromboembolism. As a difficult diagnosis in these patients, psychiatrists and vascular physicians should be aware of this association. Read More

Brain Stimul 2019 Mar - Apr;12(2):329-334. Epub 2018 Dec 4.

Metro South Addiction and Mental Health, Brisbane, Australia; University of Queensland, Brisbane, Australia.

Background: Anti-NMDA receptor encephalitis most commonly presents with psychiatric symptoms such as behavioural disturbance, catatonia and psychosis. Although the primary treatment is with immunomodulatory therapy, psychiatric symptoms often require adjuvant management. Side effects and treatment resistance limits the use of psychotropics, but the role of ECT has been minimally reviewed. Read More

Acta Psychiatr Scand 2019 Jan 2;139(1):46-55. Epub 2018 Dec 2.

Kennedy Krieger Institute, Baltimore, MD, USA.

Objective: To review the treatment courses of 22 autistic patients diagnosed with catatonia over a 12-year period, including treatment with benzodiazepines and electroconvulsive therapy.

Method: Retrospective review of inpatient and outpatient records of 22 autistic youth presenting to a neurobehavioral service who were treated for catatonia.

Results: Six girls and 16 boys ranging from ages 8 to 26 years old presenting for neurobehavioral assessment were found to meet criteria for catatonia according to the DSM5 and were treated for such. Read More

World J Biol Psychiatry 2018 Dec 4:1-14. Epub 2018 Dec 4.

e Department of Psychiatry and Psychotherapy , Ludwig-Maximilians-University Munich , Munich , Germany.

Objectives: Despite intensive research, schizophrenia and schizoaffective disorders continue to be theoretical constructs that describe clinical syndromes and no pathophysiologically defined diseases. Moreover, there are no clear biomarkers at hand. Therefore, these diagnoses are still set up based on clinical ICD-10/DSM-5 criteria and the exclusion of alcohol-/drug-associated, systemic or other brain organic causes. Read More

Lancet 2018 10;392(10157):1507-1508

CNS Drugs 2019 Jan;33(1):47-60

Department of Neurology, University of California San Francisco, San Francisco, CA, USA.

Background: Purified cannabidiol is a new antiepileptic drug that has recently been approved for use in patients with Lennox-Gastaut and Dravet syndromes, but most published studies have not extended beyond 12-16 weeks.

Objective: The objective of this study was to evaluate the long-term safety, tolerability, and efficacy of cannabidiol in children with epilepsy.

Methods: Patients aged 1-17 years with refractory epilepsy were enrolled in an open-label prospective study through individual patient and expanded access programs between April 2013 and December 2014. Read More

Handb Clin Neurol 2018 ;157:663-675

Department of Emergency Medicine, Division of Medical Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States. Electronic address:

The clinical manifestation of drug-induced abnormalities in thermoregulation occurs across a variety of drug mechanisms. The aim of this chapter is to review two of the most common drug-induced hyperthermic states, serotonin syndrome and neuroleptic malignant syndrome. Clinical features, pathophysiology, and treatment strategies will be discussed, in addition to differentiating between these two syndromes and differentiating them from other hyperthermic or febrile syndromes. Read More

J Clin Neurosci 2019 Jan 16;59:185-189. Epub 2018 Nov 16.

Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address:

We aimed to study the proportion of patients with movement disorders in seropositive autoimmune encephalitis of non-neoplastic aetiology and also to describe the spectrum of movement disorders in them. We prospectively screened 362 patients of age >12 years with encephalitis of unknown aetiology for a panel of antibodies for autoimmune encephalitis. Demographic and clinical characteristics with focus on the movement disorders were recorded. Read More

Prim Care Companion CNS Disord 2018 Nov 1;20(6). Epub 2018 Nov 1.

Psychiatry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.

Clin Pract Cases Emerg Med 2018 Nov 15;2(4):369-370. Epub 2018 Aug 15.

The University of Tokyo Hospital, Department of Acute Medicine, Hongo, Bunkyo-ku, Tokyo, Japan.

J Child Adolesc Psychopharmacol 2018 Nov 14;28(9):663-666. Epub 2018 Nov 14.

Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Leonard M. Miller School of Medicine, University of Miami , Miami, Florida.