Catatonia of various causes is said to generally benefit from the effect of benzodiazepines. However, at present it cannot be said that catatonia is a homogeneous condition. Because of impressive cases showing dramatic improvement by benzodiazepine drugs and electroconvulsive therapy (ECT) treatment, we may tend to conduct diagnoses, evaluations and treatments in a casual manner. Catatonia is a syndrome characterized by impaired psychomotor movement, and therefore it is difficult for patients to describe their own symptoms and conditions. These symptoms also include those not limited to catatonia, such as stupor. Therefore, it is important for the diagnosis to evaluate whether the overall image shown by the patient is catatonic.
 In using benzodiazepine drugs, it is of course necessary to pay attention to whether they have a positive effect on the "symptoms called catatonia" and "the basic diseases causing catatonia". It should be considered that a good outcome might not be obtainable without a therapeutic approach toward underlying diseases possibly causing the catatonia.
 It has been pointed out that early treatment intervention following the occurrence of catatonia symptoms has a great influence on outcome, so it seems that we must not hesitate to administer benzodiazepines. However, for that purpose, we consider it necessary to sufficiently examine the symptoms of catatonia, investigate the possibility of adverse events occurring by the administration of benzodiazepines, and promptly conduct a differential diagnosis as well as a diagnosis of the underlying disease. In the course of treatment, the influence on the cardiovascular system must be fully examined, and ECT should be decisively selected for the purpose of treatment of the underlying disease or for the purpose of avoiding a lethal outcome.
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