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Case Reports: Clozapine for the Treatment of Catatonia in Autism Spectrum Disorder

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Abstract

Catatonia is a severe clinical syndrome which has been increasingly reported in autism spectrum disorder (ASD). The prevalence of catatonia in ASD is unknown. Diagnosing catatonia in ASD is complicated by overlapping clinical features such as mutism, stereotypies, and echophenomena. Here, we present the clinical histories of two individuals with ASD and catatonia who were successfully treated with clozapine. We have reported on a novel potential treatment option for catatonia in ASD. Additional studies are needed to evaluate the safety, efficacy, and tolerability of clozapine for the treatment of catatonia in ASD.

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References

  • Billstedt, E., Gillberg, C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35(3), 351–360.

    Article  Google Scholar 

  • Chattopadhyay, S., Saha, I., Dan, A., & Bhattacharyya, K. (2012). Clozapine responsive catatonia: A series of five cases. Industrial Psychiatry Journal, 21(1), 66.

    Article  Google Scholar 

  • Collins, J., Halder, N., & Chaudhry, N. (2012). Use of ECT in patients with an intellectual disability: Review. The Psychiatrist, 36(2), 55–60.

    Article  Google Scholar 

  • DeJong, H., Bunton, P., & Hare, D. J. (2014). A systematic review of interventions used to treat catatonic symptoms in people with autistic spectrum disorders. Journal of Autism and Developmental Disorders, 44(9), 2127–2136.

    Article  Google Scholar 

  • Dhossche, D. M., Shah, A., & Wing, L. (2006). Blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders. International Review of Neurobiology, 72, 267–284.

    Article  Google Scholar 

  • Dhossche, D. M., & Stanfill, S. (2004). Could ECT be effective in autism? Med Hypotheses [internet], 63(3), 371–376.

    Article  Google Scholar 

  • Ellul, P., Rotgé, J. Y., & Choucha, W. (2015). Resistant catatonia in a high-functioning autism spectrum disorder patient successfully treated with amantadine [Internet]. Journal of Child and Adolescent Psychopharmacology, 25(9), 726.

    Article  Google Scholar 

  • England, M. L., Öngür, D., Konopaske, G. T., & Karmacharya, R. (2011). Catatonia in psychotic patients: Clinical features and treatment response. Journal of Neuropsychiatry and Clinical Neurosciences, 23(2), 223–226.

    Article  Google Scholar 

  • Fink, M., Taylor, M. A., & Ghaziuddin, N. (2006). Catatonia in autistic spectrum disorders: A medical treatment algorithm. International Review of Neurobiology, 72, 233–244.

    Article  Google Scholar 

  • Ghaziuddin, N., Dhossche, D., & Marcotte, K. (2012). Retrospective chart review of catatonia in child and adolescent psychiatric patients. Acta Psychiatrica Scand., 125(1), 33–38.

    Article  Google Scholar 

  • Honigfeld, G., Arellano, F., Sethi, J., Bianchini, A., & Schein, J. (1998). Reducing clozapine-related morbidity and mortality: 5 years of experience with the Clozaril National Registry. Journal of Clinical Psychiatry, 59(SUPPL. 3), 3–7.

    PubMed  Google Scholar 

  • Horder, J., Petrinovic, M. M., Mendez, M. A., et al. (2018). Glutamate and GABA in autism spectrum disorder-a translational magnetic resonance spectroscopy study in man and rodent models. Translational Psychiatry, 8(1), 106.

    Article  Google Scholar 

  • Jann, M. W. (1991). Clozapine. Pharmacother J Hum Pharmacol Drug Ther, 11(3), 179–195.

    Google Scholar 

  • Lamberti, J. (2006). Prevalence of the metabolic syndrome among patients receiving clozapine. American Journal of Psychiatry, 163(7), 1273.

    Article  Google Scholar 

  • Marrosu, F., Marrosu, G., Rachel, M. G., & Biggio, G. (1987). Paradoxical reactions elicited by diazepam in children with classic autism. Functional Neurology, 2(3), 355–361.

    PubMed  Google Scholar 

  • Meltzer, H. Y. (2012). Clozapine: Balancing safety with superior antipsychotic efficacy. Clinical Schizophrenia & Related Psychoses, 6(3), 134–144.

    Article  Google Scholar 

  • Pelzer, A. C. M., van der Heijden, F. M. M. A., & den Boer, E. (2018). Systematic review of catatonia treatment. Neuropsychiatric Disease and Treatment, 14, 317–326.

    Article  Google Scholar 

  • Rosebush, P. I., & Mazurek, M. F. (2010). Catatonia and its treatment. Schizophrenia Bulletin, 36(2), 239–242.

    Article  Google Scholar 

  • Sienaert, P., Dhossche, D. M., Vancampfort, D., De Hert, M., & Gazdag, G. (2014). A clinical review of the treatment of catatonia. Front Psychiatry. https://doi.org/10.3389/fpsyt.2014.00181/full

    Article  PubMed  PubMed Central  Google Scholar 

  • Siskind, D., McCartney, L., Goldschlager, R., & Kisely, S. (2016). Clozapine v first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry, 209(5), 385–392.

    Article  Google Scholar 

  • Wing, L., & Shah, A. (2000). Catatonia in autistic spectrum disorders. British Journal of Psychiatry, 176, 357–362.

    Article  Google Scholar 

  • Wu, Y., Blichowski, M., Daskalakis, Z. J., et al. (2011). Evidence that clozapine directly interacts on the GABAB receptor. NeuroReport, 22(13), 637–641.

    Article  Google Scholar 

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Acknowledgements

This work was funded by the Nancy Lurie Marks Family Foundation.

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RPT and CJM drafted the manuscript, reviewed the final version, and gave approval for its submission.

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Correspondence to Christopher J. McDougle.

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Thom, R.P., McDougle, C.J. Case Reports: Clozapine for the Treatment of Catatonia in Autism Spectrum Disorder. J Autism Dev Disord 52, 2855–2858 (2022). https://doi.org/10.1007/s10803-021-05149-8

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