On Catatonia: Why It’s Missed, Misunderstood, and Mismanaged

In this episode of On the Mind, host Dr. Daniel Knoepflmacher speaks with Dr. Leonardo Lopez, the Vice Chair of Inpatient Services in Psychiatry at Weill Cornell Medicine, about the critical and often misunderstood syndrome of catatonia. Drawing from the history of this diagnosis, they examine why this life-threatening condition is frequently hidden in plain sight, often missed or mistaken for other conditions. With vivid examples from his extensive clinical experience, Dr. Lopez reframes catatonia as a transdiagnostic 'paralysis of the will.' In clear and accessible terms, he shares how clinicians can identify subtle warning signs like repetitive stereotypies, mannerisms, and echophenomena.

The conversation also covers the severe medical consequences of catatonia and outlines the rapid, highly reliable recovery options available through high-dose lorazepam trials and electroconvulsive therapy (ECT). This is a vital, clinically grounded discussion that demonstrates how overcoming diagnostic misconceptions can bridge the gap between psychiatry and medicine to safely and reliably improve care for patients facing this life-threatening condition.