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Catatonia

marijuana for catatonia

Medical Marijuana and Catatonia

Doctors associate catatonia with schizophrenia and other mental illnesses. As you may know, mental illness can impact your quality of life. There’s feeling sad every day, appetite changes, difficulty concentrating, fatigue, depression, sleep issues, and many other symptoms you can experience with mental illnesses.

You want relief, and while there are treatments available to tackle these symptoms, they often come with harsh side effects. Many patients are now exploring medical cannabis for catatonia and are experiencing good results.

What Is Catatonia?

Catatonia is an abnormal neuropsychiatric illness affecting both motor function and behavior. An individual experiencing catatonia appears to be awake but is unresponsive.

There are three types of catatonia:

  1. Catatonic disorder due to another medical condition.
  2. Catatonia linked with another mental disorder.
  3. Unspecified catatonia.

Catatonia has an association with mental illnesses such as:

  • Severe depression
  • Schizophrenia
  • Psychosis
  • Bipolar disorder

However, physicians see numerous other reasons for catatonia ranging from psychiatric causes to an overabundance of medical illnesses like Parkinson’s disease or encephalitis.

Catatonia sometimes also goes by the name catatonic syndrome, since there’s more than one identifying sign associated with the disorder or multiple symptoms appear all at once rather than appearing separately from one another. Symptoms don’t vary, regardless of the condition’s nature.

Symptoms of Catatonia

Three or more of the symptoms below indicate a clinical catatonic state:

  • Posturing or catalepsy: The individual either actively maintains or passively induces an unnatural posture despite the direction of gravity.
  • Being in a stupor: The individual isn’t actively relating to the environment or moving their body and maintains a fixed position. Posture and muscles appear rigid.
  • Waxy flexibility: There’s a minimal but even resistance when an examiner tries to reposition the individual.
  • Negativism: No response or opposition to external stimuli or instructions.
  • Mutism: Very little or no verbal response despite the fact there’s no neurological deficit like stroke or traumatic brain injury that could inhibit speech.
  • Stereotypy: Displays abnormally frequent, repetitive, non-goal-directed movements.
  • Mannerism: Displaying caricature of regular actions.
  • Grimacing: Making an overemphasized facial expression of disgust.
  • Agitation: Being agitated where external stimuli have no influence.
  • Echopraxia: Mimicking the movements of another person.
  • Echolalia: Mimicking the speech of another person.

If you’re struggling with catatonic depression, you could also experience depression symptoms such as:

  • Loss of interest in many activities
  • Feelings of sadness that could occur almost every day
  • A change in appetite
  • Sudden weight loss or gain
  • Trouble falling asleep
  • Feelings of guilt
  • Feelings of worthlessness
  • Irritability
  • Difficulty thinking
  • Difficulty concentrating
  • Difficulty making decisions
  • Feelings of restlessness
  • Thoughts of death or suicide
  • A suicide attempt

Causes of Catatonia

Researchers believe an abnormal production of neurotransmitters partly causes depression. Neurotransmitters are brain chemicals that enable cells to communicate with each other.

causes of catatonia

The neurotransmitters typically linked with depression are norepinephrine and serotonin. Antidepressants like serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) work by acting on these two specific chemicals.

Researchers also believe a few causes of catatonia include abnormalities with gamma-aminobutyric acid (GABA), dopamine and glutamate neurotransmitter systems.

Underlying psychiatric, neurological and physical illnesses often accompany catatonia. Because of this, your doctor will need to target the underlying cause to successfully treat your catatonic symptoms.

Physical Effects of Catatonia

Regardless of its underlying cause, catatonia can cause different medical complications that involve every organ system, so doctors need to be aware of, make preparations for and treat the detected conditions. Some complications that doctors can address include:

  • Dehydration and malnutrition: Doctors must provide a patient with nutritional support, either through the digestive system (enteric feeding) or intravenously (parenteral nutrition), as well as adequate hydration.
  • Incontinence: Requires hygiene precautions to decrease the chances of skin breakdown and severe infectious complications.
  • Prolonged staring and reduced blinking: Eye drops can prevent severe ocular complications such as ocular pain, ocular surface irritation and decreased vision due to tear formation reduction.

Immobility puts the individual at risk for:

  • Contractures
  • Decubitus ulcers, also called bed sores
  • Deep venous thrombosis (DVT)
  • Infections
  • Pulmonary emboli (PE)

Researchers have associated a wide range of other complications with catatonia, including:

  • Acute renal failure
  • Adult respiratory distress
  • Cardiac arrest
  • Dehydration
  • Disseminated intravascular coagulation
  • Gastrointestinal bleeding
  • Hepatocellular damage
  • Hypoglycemia
  • Laryngospasm
  • Myocardial infarction
  • Pneumonia
  • Seizures
  • Sepsis
  • Thrombophlebitis
  • Urinary retention

Mental Effects of Catatonia

Major depressive disorder or depression is a medical condition causing individuals to experience very low moods. In some cases, depression accompanies catatonia, where the individual doesn’t respond to everything around them.

catatonia and depression

While catatonic depression was once seen as a separate condition, the American Psychiatric Association (APA) doesn’t see it as a distinct mental illness any longer. Instead, the APA now recognizes catatonia as a specifier or subcategory of other numerous mental illnesses including bipolar disorder, post-traumatic stress disorder, and depression.

Some individuals with schizophrenia may develop catatonia. With this, the person will have periods where they move very little and don’t respond to instructions. In other cases, the person demonstrates a motor activity that’s “peculiar” and “excessive,” such as mimicking others’ movements or sounds. This is known as catatonic excitement.

Catatonia Statistics

Statistics reported by the National Center for Biotechnology Information (NCBI) include:

  • Rates of catatonia, in retrospective studies, among all psychiatric patients range between 0.5 percent to 2.1 percent.
  • Certain prospective studies show the incidence can be as high as 17.1 percent.
  • Studies of epidemiology and incidence of catatonia focus most on psychiatric patients.
  • One retrospective and prospective study showed the catatonia rate was around 24.4 percent.
  • Rates have been higher among individuals with mood disorders, ranging from 13 percent to 27 percent.

Most studies on the catatonia incidence show it to be between five and 20 percent in the acute inpatient psychiatric setting. You can classify many catatonia episodes as malignant, excited or retarded. Symptoms can come and go or change during the episodes, and individuals can experience periods of excitation and periods of withdrawal.

Catatonia History

Since its initial description, catatonia remains a poorly defined disorder marked by disturbed mood behavior originally described with severe mental illness.

Karl Ludwig Kahlbaum coined the term “catatonia” in 1874, describing a syndrome “with an alternating, cyclic course in which mental symptoms are without interruption as follows: mania, melancholy, confusion, stupor and eventually, dementia.”

Later on, Emil Kraepelin suggested catatonia be classified phenomenologically with other types of dementia praecox — paranoia and hebephrenia. Because of Eugen Bleuler’s work, the term “catatonia” became synonymous with behavioral withdrawal and immobility — a symptom often associated with schizophrenia.

Current Treatments Available for Catatonia and Their Side Effects

Doctors may prescribe the following treatments for catatonia:

1. Benzodiazepines

These are psychoactive drugs that enhance the GABA neurotransmitter’s effect. In most individuals, benzodiazepines are effective for fast relief of catatonic symptoms, including muscle spasms, anxiety and insomnia.

However, these medications are also incredibly addictive. Therefore physicians generally only prescribe them for short-term treatment use.

Side effects of benzodiazepines may include:

  • Confusion
  • Dizziness
  • Drowsiness
  • Feelings of depression
  • Grogginess
  • Headache
  • Impaired coordination
  • Trembling
  • Vision problems

2. Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a highly effective catatonic depression treatment. The doctor attaches electrodes to the patient’s head. These electrodes then send electrical impulses to the patient’s brain, triggering a seizure.

While ECT is an effective and safe treatment for many different mental illnesses and mood disorders, stigma still surrounds it. Because of this, it presently lags behind benzodiazepines as the primary treatment for symptoms of catatonia.

3. N-Methyl-D-Aspartate

Doctors can use N-methyl-D-aspartate to treat catatonic depression. It’s also effective and is an amino acid derivative that mimics glutamate neurotransmitter behavior. While it seems to offer promise as a treatment, more studies are needed to address its side effects and effectiveness adequately.

Some of the side effects already known about include:

  • Agitation
  • Alterations in mood
  • Anesthesia
  • Ataxia
  • Catatonia
  • Confusion
  • Difficulty concentrating
  • Hallucinations
  • Nightmares
  • Memory and learning deficits
  • Paranoid delusions

4. Repetitive Transcranial Magnetic Stimulation (rTMS)

Other treatments showing promise are rTMS and some atypical antipsychotics, especially those blocking dopamine D2 receptors.

Recent Developments in Catatonia

Several clinical trials are being conducted to study different developments in catatonia. Some of them include:

  1. Personalized Non-invasive Neuromodulation by rTMS for Chronic and Treatment Resistant Catatonia.
  2. Anatomical and Structural Connectivity in Two Psychotic Phenotypes.
  3. Prospective Treatment Study of Catatonia Patients.

effective treatments

How Marijuana Can Be an Effective Treatment for Catatonia

Some studies have shown promise in the use of cannabis in the treatment of catatonia. These include:

1. Cannabis and Schizophrenia

A preliminary clinical trial shows a compound found in marijuana helps to treat schizophrenia just as effectively as antipsychotic medicines, but with far fewer negative side effects.

Researchers studied 39 individuals with schizophrenia who had a psychotic episode and physicians hospitalized them. They treated 19 individuals with amisulpride, a type of antipsychotic medicine not approved in the U.S., but comparable with other drugs that are.

The researchers gave the remaining people cannabidiol (CBD), a cannabinoid in cannabis thought to have anxiety-reducing or mellowing effects. Unlike tetrahydrocannabinol (THC), the primary psychoactive component in marijuana which can make schizophrenia worse, CBD has antipsychotic effects.

Neither the patients nor the researchers knew who was receiving which treatment. The trial lasted four weeks, and once completed, both groups showed substantial improvements in their symptoms of schizophrenia — researchers saw no difference between amisulpride or CBD.

The study shows CBD was not only just as effective as antipsychotic drugs, but it doesn’t come with the standard negative side effects you see with antipsychotic medications.

2. Cannabis and Bipolar Disorder

A 2015 study showed medical weed used in some individuals with bipolar disorder promoted a more positive outlook and enhanced their mood.

Additionally, a 2016 study showed individuals with bipolar disorder, when using medical pot, didn’t experience substantial mental impairment compared to those with the condition who didn’t use the herb. Critics of cannabis use for bipolar disorder state it affects an individual’s memory and thinking. This was not found to be true in this study. The study found that after the bipolar patients used cannabis, they also experienced better moods.

In Relation to Parkinson’s Disease

Marijuana for catatonia could be a great addition to or an alternative to the treatment plan for Parkinson’s disease as a cause of catatonia.

Some conventional medicines doctors prescribe for a patient with Parkinson’s also come with side effects that aren’t present in cannabis. The herb does have minimal side effects, however, including:

  • Heightened sensory perception
  • Thirst and dry mouth
  • Hunger
  • Slower reaction time
  • Red eyes
  • Constipation
  • Short-term memory loss
  • Drowsiness
  • Impaired balance

Cannabis for catatonia provides a combination of antioxidant, anti-anxiety and pain relief all in one treatment.

What Side Effects or Symptoms of Catatonia Can Medical Marijuana Treat?

Medical marijuana for catatonia can help treat many of the symptoms of catatonic depression, including:

  • Feelings of sadness
  • Sudden weight loss
  • A loss of interest in many activities
  • Appetite change
  • Feelings of restlessness
  • Trouble falling asleep
  • Irritability
  • Fatigue (Sativa strains are good for this)
  • Feelings of worthlessness
  • Suicidal thoughts or attempt

Symptoms of catatonic schizophrenia that marijuana can treat include:

  • Anger or elevated mood
  • General discontent
  • Fatigue
  • Loss of interest or pleasure
  • Anxiety and depression
  • Obsessive-compulsive disorder (OCD)
  • Abnormal motor behavior
  • Fatigue
  • Abuse of alcohol or drugs
  • Social withdrawal
  • Inappropriate emotional response

Best Strains of Marijuana to Use for Symptoms of Catatonia

Here are some effective medical marijuana strains that can help patients with catatonia.

1. Catatonic Schizophrenic Strains

Although individuals with schizophrenia need to stay away from strains with THC, because it would stimulate their already excited mind, strains with CBD work well because CBD is a potent antipsychotic. It also counteracts THC’s effects. So, you’ll want to choose strains high in CBD with little to no THC.

use cbd strains

Some strains you may want to try include:

  • Charlotte’s Web (Sativa)
  • Remedy (Indica-dominant hybrid)
  • ACDC (Hybrid)
  • Avidekel (Hybrid)

2. Catatonic Depression Strains

For depression, here are some strains to try:

  • Jack Herer (Sativa)
  • Harlequin (Hybrid)
  • Pineapple Express (Hybrid)

3. Bipolar Strains

To combat catatonia accompanying bipolar disorder, try these strains:

  • Blue Dream (Hybrid)
  • Sour Diesel (Sativa)
  • Jack Herer (Sativa)

4. Anxiety Strains

Here are some strains you might try for anxiety:

  • Grandaddy Purple (Indica)
  • Girl Scout Cookies (Hybrid)
  • Northern Lights (Indica)

Best Methods of Marijuana Treatment to Use to Treat Side Effects and Symptoms of Catatonia

While most individuals connect cannabis with smoking, there are various other methods you can use to reap the medicine’s benefits. An excellent method to use for catatonia is CBD oil. It doesn’t give you any psychological effects and is low in THC. Some are purely CBD.

If you don’t want to smoke it, there are numerous other methods you can use to receive your CBD oil.

You can use your CBD oil in:

The best method for many users is CBD inhalers. For fast relief, you can vape your oil. Vaping delivers quick comfort without inhaling harmful smoke. However, if you have lung-related issues, you should avoid vaping just as you would smoking.

catatonia relief

Find Catatonia Relief With Medical Marijuana

At Marijuana Doctors, our goal is to provide up-to-date, accurate information on medical marijuana as well as connect you with the resources you need to begin your medical marijuana journey. If you still have questions or concerns, we can connect you with a licensed cannabis doctor who can answer all your questions and help tailor a marijuana treatment plan to help with your catatonia symptoms. You can also find a dispensary. Book your appointment today to start feeling relief.

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Resources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292429/
  2. http://healthland.time.com/2012/05/30/marijuana-compound-treats-schizophrenia-with-few-side-effects-clinical-trial/
  3. http://www.medlink.com/article/catatonia
  4. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118916

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