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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1127

Treatment approach in acute psychosis with catatonic features: from diazepam and cannabidiol to full remission with lorazepam

THERAPEUTIC APPROACH TO ACUTE PSYCHOSIS WITH CATATONIC FEATURES: FROM DIAZEPAM AND CBD TO FULL REMISSION VIA LORAZEPAM

Full remission was achieved with injectable lorazepam 4 mg/day in acute psychosis with catatonic features unresponsive to antipsychotics.

The aim of this presentation is to describe the clinical management of a complex symptom profile involving co-occurring catatonia, dissociative stupor, and autonomic dysfunction in late adolescence. A 17-year-old female patient presenting with selective mutism, refusal of food and fluids, and autonomic instability was admitted to an adult psychiatric unit; nasogastric tube placement was required due to tachycardia and urinary retention. Initial antipsychotic trials (olanzapine 15 mg, haloperidol 10 mg, paliperidone 5 mg) produced a poor clinical response. Diazepam 40 mg/day, used as bridging therapy, provided a partial response and partial restoration of mobility, while adjunctive 20% cannabidiol (CBD) at 3 cc/day provided anxiolytic support. Full remission was achieved with injectable lorazepam 4 mg/day, with resolution of catatonia and restoration of speech and vital functions. Following remission, command auditory hallucinations associated with food refusal emerged, confirming an underlying psychotic process. The authors emphasize that benzodiazepines remain the gold standard for acute catatonia, that high-dose diazepam may provide a stabilizing bridge when medication access is limited, and that a rapid response may reveal the underlying psychotic disorder.

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