Catalepsy: Signs, Causes, Treatment, and Coping

Catalepsy involves a loss of voluntary motion, muscle rigidity, fixed posture, and decreased sensitivity to pain. It is a symptom of a number of conditions including epilepsy, Parkinson's disease, substance use, catatonia, schizophrenia, and as a side effect of some types of medication used to treat schizophrenia.

This article discusses some of the signs that someone is experiencing catalepsy, the conditions that may cause this symptom, and how it might be treated. 

Signs of Catalepsy

Some of the signs of catalepsy include:

• Decreased or slowed movement
• Decreased muscle control
• Decreased sensitivity to pain 
• Loss of muscle control
• Rigid body posture
• Rigid limbs
• Slowed breathing
• Slowed body functions
• Waxy flexibility (limbs remain in the same position when moved)

Waxy flexibility is associated with conditions such as bipolar disorder and schizophrenia. People experiencing this symptom only slightly resist having their body or limbs moved into a different position. The individual will then remain in this new position without making any attempts to reposition the body.

People who are experiencing catalepsy are less sensitive not only to pain but to touch in general. When a person is experiencing this symptom, they seem non-responsive and do not respond to speech. 

Identifying Catalepsy

If a person is experiencing catalepsy, a doctor may observe this symptom and consider a person’s medical history and other symptoms in order to make a diagnosis. A doctor may perform a physical exam and run lab tests to look at factors that may be contributing to a person’s symptoms.

The diagnosis that a doctor makes will depend on what other symptoms a person is experiencing. For example, a person who experiences catalepsy along with echolalia, stupor, and mutism might be diagnosed with catatonia. 

Causes of Catalepsy

Catalepsy is not a distinct condition in and of itself but is instead a symptom of some types of nervous disorders and other conditions. Some of the conditions that may cause catalepsy include:

• Catatonia
• Cocaine withdrawal
• Epilepsy
• Ketamine use
• Parkinson's disease

According to a 2013 study, catalepsy results from the blockage of certain dopamine receptors in the neural circuits associated with motor behavior.

It can also occur as a side effect of some antipsychotic medications that are used to treat schizophrenia and bipolar disorder, including haloperidol. This side effect can play a role in medication adherence for people with schizophrenia.

Catalepsy accompanied by waxy flexibility or rigid, immobile limbs was once a staple of stage hypnosis. Hypnotists would suggest that the individual could not move and then position the individual poses that the individual would remain in until the hypnotist ended the hypnotic trance.

Treatment for Catalepsy

The treatment for catalepsy depends on the underlying condition that is causing this symptom. Once a diagnosis has been made, healthcare providers will recommend treatments to address the underlying cause. Cases of catalepsy caused by stress or trauma often ease over time. In such cases, psychotherapy may also be helpful.

Some treatments that might be used to help ease catalepsy include:

• Antipsychotic medications: If catalepsy is connected to a psychotic disorder such as schizophrenia or catatonia, an antipsychotic medication may be prescribed.
• Muscle relaxants: Some people may find that muscle relaxants help reduce the muscle, limb, and postural rigidity caused by catalepsy.

Research has also indicated that adenosine antagonists might be useful in the treatment of haloperidol-induced catalepsy. In one study, caffeine, a non-selective adenosine antagonist, was found to significantly reduce catalepsy and improve movement.

One 2018 study found that deep brain stimulation (DBS) was effective in relieving haloperidol-induced catalepsy in individuals with Parkinson's disease. Deep brain stimulation is a surgical technique in which a device is implanted inn specific areas of the brain in order to deliver small electrical shocks.

Other treatments may be on the horizon as researchers learn more about the causes of catalepsy. In a 2020 study published in Translational Psychiatry, researchers found that haloperidol-induced catalepsy is caused by an area of the brain call the striatum.

According to the results of the research, a key protein known as mTOR plays a pivotal role in dopamine 2 signaling. When this protein is over-produced or under-produced in the brain’s striatum, it can contribute to serious disorders and problems such as catalepsy.

The study also found that a medication used to prevent rejection in organ transplants and other procedures can prevent or remedy cases of catalepsy induced by haloperidol.

The use of this medication to treat this type of catalepsy was discovered by accident. Researchers were using haloperidol and rapamycin in their studies of the striatum when they noticed the effect. 

While promising, it is important to note that more research is needed to better understand how such treatments might be best utilized.

Coping With Catalepsy

If you believe someone is experiencing catalepsy, you should seek medical attention. Catalepsy can be potentially dangerous and a person exhibiting signs should be evaluated to help ensure their safety. A healthcare provider can then determine what might be contributing to this symptom and provide treatments that can help. 

For catalepsy caused by other conditions such as Parkinson’s disease or epilepsy, your doctor will work with you to develop a treatment plan that is right for your needs.

A Word From Verywell

Catalepsy can be a serious and concerning symptom of a number of health conditions. If you or someone you love is experiencing this symptom, your first step should be to seek medical attention for the appropriate diagnosis and treatment.