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| Case report | Country and year of study | Treatment intervention | Outcome |
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| D’Urso et al. [9] | Italy, 2012 | ECT with clonazepam, paroxetine, and perphenazine | (i) BPRS (Brief Psychiatric Rating Scale) score decreased by 49% (from 79 to 40); CGI-severity item changed from “among the most extremely ill (7/7)” to “markedly ill (5/7)”
(ii) The core component of the same scale showed
(iii) A 42% reduction of obsessive-compulsive symptoms (from 38 to 22)
(iv) Hamilton Depression Rating Scale (HAM-D) score decreased from 21 to 9 (57%), and Hamilton Anxiety Rating Scale decreased (HAM-A) from 19 to 10 (47%) |
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| Duarte-Batista et al. [8] | Portugal, 2020 | Bilateral DBS of the anterior limb of the internal capsule (ALIC)/bed nucleus of stria terminalis (BST) region was performed, using a target below the BST and a trajectory through the ALIC, with stimulation of contacts 0 and 3 | (i) Two weeks after surgery, sedatives were suspended, and the patient was successfully extubated
(ii) One year after surgery, the patient reached a YGTSS (Yale Global Tic Severity Scale) of 19, representing an 81% improvement. OCD is completely resolved
(iii) Adverse events were a superficial infection and weight gain
(iv) In conclusion, this ALIC/BST stimulation appears to have been an effective and safe treatment for Gilles de la Tourette syndrome (GTS) with OCD in this case |
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| Hermesh et al. [14] | Israel, 1989 | In one instance, clomipramine was utilized, and in another, behavior therapy | (i) Neuroleptics were ineffective in treating catatonic symptoms, whereas traditional OCD treatments were effective |
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| Fontenelle et al. [4] | Brazil, 2007 | Antiobsessional drugs and anticatatonia measures | (i) Treatment plan for patients with OCD and comorbid catatonia entails a number of steps, like fine-tuning the antiobsessional therapy, managing cooccurring disorders that may lead to catatonia, stopping, and then slowly restarting medications |
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| Jaimes-Albornoz et al. [16] | Spain, 2021 | OCD treatment | (i) Optimization of OCD treatment helped to resolve symptoms of catatonia |
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| Mukai et al. [18] | USA, 2011 | Aripiprazole, memantine, and lorazepam were among the psychopharmacological medications used. Addition of fluvoxamine to target obsessive-compulsive disorder- (OCD-) like symptoms
A thorough medical examination identified a cervical spine hemangioma, which was surgically removed and improved neck posture | Clinical improvement was seen after adding fluvoxamine to treat obsessive-compulsive disorder- (OCD-) like symptoms, pointing to OCD as a potential contributor to this patient’s protracted catatonic condition |
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| Nikjoo et al. [19] | USA, 2022 | Lorazepam | Catatonic symptoms were successfully treated at the expense of developing a subtype of OCD known as scrupulosity |
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| Blacker [11] | USA; 1966 | Psychotherapy, phenothiazine | Improvement over the course of 5 years |
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| Eryilmaz et al. [13] | Turkey, 2014 | Aripiprazole, clozapine, fluvoxamine, clonazepam, and ECT therapy were used | (i) Pharmacotherapy was carried out as aripiprazole 30 mg per day, biperiden 4 mg per day, and pimozide 2 mg per day. ECT was begun because of no responsiveness to pharmacotherapy
(ii) After the third session of ECT, recurrent ritual behavior and posturing were observed
(iii) The patient had obsessions such as trying not to forget thoughts in case they become needed and being able to pass to another thought after touching things. Pimozide was discontinued
(iv) Aripiprazole dose was decreased to 20 mg per day. Fluvoxamine 100 mg per day and clonazepam 6 mg per day were added to the treatment regime. ECT was discontinued after the 10th session
(v) The patient was discharged with partial remission on aripiprazole 20 mg per day, clonazepam 2 mg per day, and fluvoxamine 200 mg per day |
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| Elia et al. [12] | USA, 2005 | (i) Plasmapheresis
(ii) Lorazepam | (i) OCD symptoms significantly and quickly improved after plasmapheresis, and basal ganglia edema also decreased, which is consistent with an immune-mediated pathophysiological process involving group A beta-hemolytic streptococci
(ii) The symptoms of attention-deficit/hyperactivity disorder may be signs of catatonia as impulsivity, hyperactivity, and inattention decreased with lorazepam |
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| Jagadheesan et al. [15] | India, 2002 | Patient 1: for catatonic signs, injection lorazepam
For OCD with catatonia, a combination of clomipramine and risperidone subsequently combined clomipramine, thioridazine, and buspirone
Patient 2: for catatonic schizophrenia, electroconvulsive therapy (ECT). Then, amitriptyline and lithium, with the second trial of ECT and a combination of imipramine and trifluoperazine | Patient 1: after lorazepam, symptoms were not relieved, and depression was noted. Then, with initial combination therapy, the symptoms worsened. Subsequent combination therapy relieved the symptoms
Patient 2: initial ECT and combination therapy were inadequate to treatment. With the addition of a further second trial of ECT, drugs responded well |
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| Sachdeva et al. [20] | India, 2015 | Trifluoperazine, fluoxetine, trihexyphenidyl, and phenytoin | (i) With combination therapy, the patient showed significant improvement over the subsequent six weeks of admission; the Brief Psychiatric Rating Scale (BPRS) dropped from 42 to 24
(ii) The Yates-Brown Obsessive Compulsive Symptoms (YBOCS) scale dropped from 24 to 18
(iii) The Global Assessment of Functioning (GAF) scale increased from 25 to 55
(iv) After 6 months of discharge, the patient had good improvement |
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| Makhinson et al. [17] | USA, 2012 | Olanzapine, lorazepam, and fluoxetine
Then, ECT and combination of above drugs | (i) She was discharged with lorazepam and fluoxetine. One month after discharge, revealed continued remission from catatonia but a mild return of her OCD symptoms |
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