Psychiatric Annals

Feature Articles 

Catatonia in French Psychiatry: Implications of the Zolpidem Challenge Test

Pierre Thomas, MD; Olivier Cottencin, MD; Claire Rascle, MD; Guillaume Vaiva, MD; Michel Goudemand, MD; Jacques Bieder, MD

Abstract

Catatonia is a complex clinical condition with impairment of psychomotor function, the physiopathology of which remains unclear. For many years, French psychiatry adopted the Kraepelinian position classifying catatonia exclusively as a form of schizophrenia. The therapeutic success obtained with benzodiazepines prompted re-evaluation of this concept of catatonia. However, in clinical practice, catatonia still remains under-recognized resulting in treatment delays and increasing the risk of complications. In France, the use of zolpidem in catatonia, described by our team 10 years ago, has been used as a therapeutic challenge test to facilitate diagnosis and treatment of catatonia. Zolpidem also has been reported to improve other psychomotor disorders, thereby attracting interest in its specific pharmacologic properties in relation to mechanisms underlying catatonia.

ABOUT THE AUTHORS

Pierre Thomas, MD; Olivier Cottencin, MD; Claire Rascle, MD; Guillaume Vaiva, MD; Michel Goudemand, MD; and Jacques Bieder, MD, are with the Psychiatry Department, Hôpital M. Fontan, CHRU Lille, University of Lille France.

Address correspondence to: Pierre Thomas, MD, Psychiatry Department, Hôpital M.Fontan, CHRU Lille, Rue Verhaghe 59037 Lille, France; fax: 33 320 44 65 62; or email pthomas@chru-lille.fr.

Dr. Thomas is a research grant recipient for Sanofi-Aventis, the manufacturer of Ambien (zolpidem).

Abstract

Catatonia is a complex clinical condition with impairment of psychomotor function, the physiopathology of which remains unclear. For many years, French psychiatry adopted the Kraepelinian position classifying catatonia exclusively as a form of schizophrenia. The therapeutic success obtained with benzodiazepines prompted re-evaluation of this concept of catatonia. However, in clinical practice, catatonia still remains under-recognized resulting in treatment delays and increasing the risk of complications. In France, the use of zolpidem in catatonia, described by our team 10 years ago, has been used as a therapeutic challenge test to facilitate diagnosis and treatment of catatonia. Zolpidem also has been reported to improve other psychomotor disorders, thereby attracting interest in its specific pharmacologic properties in relation to mechanisms underlying catatonia.

ABOUT THE AUTHORS

Pierre Thomas, MD; Olivier Cottencin, MD; Claire Rascle, MD; Guillaume Vaiva, MD; Michel Goudemand, MD; and Jacques Bieder, MD, are with the Psychiatry Department, Hôpital M. Fontan, CHRU Lille, University of Lille France.

Address correspondence to: Pierre Thomas, MD, Psychiatry Department, Hôpital M.Fontan, CHRU Lille, Rue Verhaghe 59037 Lille, France; fax: 33 320 44 65 62; or email pthomas@chru-lille.fr.

Dr. Thomas is a research grant recipient for Sanofi-Aventis, the manufacturer of Ambien (zolpidem).

Catatonia is a complex clinical condition with impairment of psychomotor function, the physiopathology of which remains unclear. For many years, French psychiatry adopted the Kraepelinian position classifying catatonia exclusively as a form of schizophrenia. The therapeutic success obtained with benzodiazepines prompted re-evaluation of this concept of catatonia. However, in clinical practice, catatonia still remains under-recognized resulting in treatment delays and increasing the risk of complications. In France, the use of zolpidem in catatonia, described by our team 10 years ago, has been used as a therapeutic challenge test to facilitate diagnosis and treatment of catatonia. Zolpidem also has been reported to improve other psychomotor disorders, thereby attracting interest in its specific pharmacologic properties in relation to mechanisms underlying catatonia.

ABOUT THE AUTHORS

Pierre Thomas, MD; Olivier Cottencin, MD; Claire Rascle, MD; Guillaume Vaiva, MD; Michel Goudemand, MD; and Jacques Bieder, MD, are with the Psychiatry Department, Hôpital M. Fontan, CHRU Lille, University of Lille France.

Address correspondence to: Pierre Thomas, MD, Psychiatry Department, Hôpital M.Fontan, CHRU Lille, Rue Verhaghe 59037 Lille, France; fax: 33 320 44 65 62; or email pthomas@chru-lille.fr.

Dr. Thomas is a research grant recipient for Sanofi-Aventis, the manufacturer of Ambien (zolpidem).

10.3928/00485713-20070101-02

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