The initial treatment of<unk>  is to stop medication that could be potentially leading to the syndrome. These may include steroids, stimulants, anticonvulsants, neuroleptics, dopamine blockers, etc. The next step is to provide a “lorazepam challenge,” in which patients are given 2 mg of IV lorazepam (or another benzodiazepine). Most patients with<unk>  will respond significantly to this within the first 15–30 minutes. If no change is observed during the first dose, then a second dose is given and the patient is re-examined. If the patient responds to the lorazepam challenge, then lorazepam can be scheduled at interval doses until the<unk>  resolves. The lorazepam must be tapered slowly, otherwise, the<unk>  symptoms may return. The underlying cause of the<unk>  should also be treated during this time. If within a week the<unk>  is not resolved, then ECT can be used to reverse the symptoms. ECT in combination with benzodiazepines is used to treat malignant<unk> . In France, zolpidem has also been used in diagnosis, and response may occur within the same time period. Ultimately the underlying cause needs to be treated. Electroconvulsive therapy (ECT) is an effective treatment for<unk>  that is well acknowledged. ECT has also shown favorable outcomes in patients with chronic<unk> . However, it has been pointed out that further high quality randomized controlled trials are needed to evaluate the efficacy, tolerance, and protocols of ECT in<unk> . Antipsychotics should be used with care as they can worsen<unk>  and are the cause of neuroleptic malignant syndrome, a dangerous condition that can mimic<unk>  and requires immediate discontinuation of the antipsychotic. Excessive glutamate activity is believed to be involved in<unk> ; when first-line treatment options fail, NMDA antagonists such as amantadine or memantine may be used. Amantadine may have an increased incidence of tolerance with prolonged use and can cause psychosis, due to its additional effects on the dopamine system. Memantine has a more targeted pharmacological profile for the glutamate system, reduced incidence of psychosis and may therefore be preferred for individuals who cannot tolerate amantadine. Topiramate is another treatment option for resistant<unk> ; it produces its therapeutic effects by producing glutamate antagonism via modulation of AMPA receptors.
Catatonia
Neuroleptic malignant syndrome
Paratonia
Childhood schizophrenia
Cataplexy
Clonus
Catalepsy
Psychomotor agitation