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To compare the efficacy of electroconvulsive therapy (ECT) with risperidone in the treatment of lorazepam non-responsive catatonia.
Inpatients with non-affective catatonia (n= 18) non-responsive to at least five-day trial of lorazepam (6-8 mg/day) were randomised into two groups in a double blind randomised design. Written informed consent was obtained. Four were dropped from the trial as they were found to have depressive catatonia. One group received true ECT (thrice weekly, n=8) plus oral placebo while the other received sham ECT plus risperidone (4-6 mg/ day). Bush-Francis Catatonia Rating Scale (BFCRS) was administered twice weekly to assess improvement in catatonic symptoms over a period of three weeks. The two groups were compared using two-way RMANOVA.
BFCRS scores reduced markedly over treatment course and this reduction was more profound in the ECT group (p=0.035). Shorter the duration of illness greater was the response (lower scores of BFCRS).
Superior clinical efficacy of ECT over neuroleptics in catatonia is confirmed by this randomized clinical trial.