Andrew Francis, PhD, MD

As a neuropsychiatric and general medical syndrome, catatonia represents an important diagnostic and treatment challenge for all clinicians given its morbidity and mortality.

A patient with lupus presents with rash, arthralgias, and altered mental status. Various symptoms, including stupor and mutism, improve with treatment but higher doses of the drug cause more sedation. How would you proceed?

Renewed interest and emerging systematic data have highlighted the frequency and pattern of catatonic presentations in psychiatric and medical settings, including in critical illness.