help with differentiating agitation in psychosis from excited type catatonia

[hebel]

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I was hoping some members here had any advice on telling the difference between the two. I've struggled with this question in the past, and I think it's important due to the relative difference in treatment between the two.

 

[thoffen]

Sometimes you can't, but motor symptoms and either negativism or automatic compliance are relatively more specific for catatonia, and are often neglected in thoroughly examining such a patient. BZDs and ECT are reasonable adjuncts to schizophrenia treatment, and I do not find antipsychotics contraindicated in catatonia unless there is evidence for NMS. I have a low threshold for trying Ativan.

 

[SmallBird]

I was hoping some members here had any advice on telling the difference between the two. I've struggled with this question in the past, and I think it's important due to the relative difference in treatment between the two.

Interesting seeing this post, as we have just had a growing number of agitated Catalonia cases - confusion, could appear psychotic, agitated, but also with abnormal tone, vital sign abnormalities, periods of mutism, and great response to lorazepam. All of our recent cases have been heavy marijuana uses with an abrupt onset of all these symptoms and no prodrome.

 

[nexus73]

A couple things. If you increase the anti psychotic and things keep getting worse, think about agitated catatonia (and think akathisia). If the patient is incontinent, seems more common in agitated catatonia.