Diazepam combined with aripiprazole in the treatment of a catatonic stupor patient with venous thrombosis: a case report

Background Catatonic stupor is a potentially life-threatening condition, with key symptoms including mutism, immobility, refusal to eat, and negativism. It may be accompanied by complications such as infection, hyperthermia, and thrombosis. When patients develop concurrent severe physical illnesses, this is very likely to cause delays in diagnosis and treatment, further increasing the risk of clinical deterioration. Methods This article reports a 52-year-old patient with schizophrenia presenting with catatonic stupor and failure to establish effective communication. The uniqueness of this case is that the patient was admitted with concurrent pulmonary infection, pulmonary embolism, and lower limb deep venous thrombosis, and modified electroconvulsive therapy (MECT) was associated with substantial clinical risks. The patient was eventually treated with a combination of diazepam and aripiprazole. During treatment, the severity of the patient’s catatonic symptoms was assessed using the Bush-Francis Catatonia Rating Scale (BFCRS). Result After combined treatment with diazepam and aripiprazole, the patient’s catatonic symptoms were relieved, and various functions gradually recovered. The BFCRS score reduction rate exceeded 70%, indicating that the expected therapeutic effect was achieved. Conclusion As a relatively safe and effective intervention regimen, the combination treatment of diazepam and aripiprazole may be applicable to high-risk catatonic patients with relative contraindications to MECT, such as those complicated with venous thrombosis, providing a new therapeutic option for catatonic stupor.