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. © 1997 John Wiley & Sons, Ltd.