What is the primary treatment for catatonic schizophrenia?

The primary treatment for catatonic schizophrenia is the use of benzodiazepines or electroconvulsive therapy (ECT). Catatonia can present with a range of symptoms, including motor abnormalities, stupor, and severe agitation, which can significantly impair a person’s functioning.

Benzodiazepines are often effective in rapidly alleviating the motor symptoms associated with catatonia, leading to improved responsiveness and overall functioning. ECT is particularly beneficial for severe cases, especially when there is a risk of harm due to the patient's inability to care for themselves or if there is a life-threatening situation due to catatonia.

Antipsychotic medication is commonly used in the overall management of schizophrenia but does not directly address the unique features of catatonia as effectively as benzodiazepines or ECT. Cognitive-behavioral therapy is less effective as a primary intervention for the acute symptoms of catatonia, as it requires a level of engagement that may not be possible in individuals who are severely affected.

Thus, the use of benzodiazepines or ECT is the most appropriate and effective primary treatment for catatonic schizophrenia.