What is the lorazepam (Ativan) dosage for a 17-year-old patient with catatonia?

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From the Research

Treatment of catatonia in adolescents typically begins with low doses of lorazepam (often 0.5-1mg) that may be gradually increased under close medical supervision, but the exact regimen must be determined by a psychiatrist or physician familiar with the patient's complete medical history. The use of lorazepam in catatonia is supported by several studies, including a case series published in 2024 1, which demonstrated marginal reduction in symptoms with high-dose lorazepam in conjunction with electroconvulsive therapy (ECT). Another study published in 2024 2 highlighted the importance of careful titration and monitoring of lorazepam doses, as some patients may require high-dose maintenance treatment.

Key considerations in the treatment of catatonia with lorazepam include:

  • Monitoring for side effects such as sedation and respiratory depression
  • Regular reassessment of symptoms
  • Administration under direct medical supervision in a hospital setting
  • Informed consent from parents or guardians
  • Emergency psychiatric evaluation before treatment begins

It is also important to note that lorazepam may be used in combination with other treatments, such as ECT, as supported by a study published in 2017 3, which found that 95% of patients fully recovered after administration of lorazepam and/or ECT. Additionally, a study published in 2025 4 highlighted the use of IM ketamine to facilitate IV access for ECT in patients with autism and hyperactive catatonia who were prescribed high-dose benzodiazepines.

Overall, while the exact dosage of lorazepam for a 17-year-old with catatonia cannot be recommended without individualized medical assessment, low doses of lorazepam (often 0.5-1mg) with gradual increase under close medical supervision is a common approach, as supported by the most recent and highest quality studies 1, 2.

References

Research

Maintenance treatment of catatonia with benzodiazepines: A case series and literature review.

Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet lapja = official journal of the Hungarian Association of Psychopharmacology, 2024

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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