The treatment of stupor associated with MRI evidence of cerebrovascular disease.

OBJECTIVE

To describe the treatment and outcome of organic stupor associated with MRI evidence of cerebrovascular disease.

DESIGN

A case series of three patients.

SETTING

An urban mental health of the elderly service in southeast London.

PATIENTS: Aged 69 years, 72 years and 78 years. Two had organic catatonic disorder and the third organic depressive disorder.

INTERVENTIONS: Diazepam, carbamazepine, antidepressants or electroconvulsive therapy (ECT).

MAIN OUTCOME MEASURES: Resolution of symptoms and discharge from hospital.

RESULTS

Symptoms resolved between 1 and 10 days. All patients were able to return home but relapsed over the following 12 months. One relapse occurred when a patient stopped diazepam and moclobemide.

CONCLUSIONS

It is proposed that the initial treatment of organic stupor associated with cerebrovascular disease should include a benzodiazepine or carbamazepine. If patients fail to respond then ECT should be considered. The safety of ECT is not known, when treating patients with depressive disorder associated with cerebrovascular disease.