Catatonia is often misunderstood as simple immobility, but it is a terrifying, life-threatening syndrome of stupor, mutism, and extreme negativism—a state where the brain is essentially “frozen.” For decades, the standard protocol has been to step on the “brake pedal” using GABA-ergic drugs like lorazepam, followed by Electroconvulsive Therapy (ECT) if medication fails. But what happens when the brakes don’t work, and ECT is medically unsafe or unavailable?

This episode analyzes a new systematic review of 10 unique case reports that suggests NMDA receptor antagonists like ketamine and esketamine could be the “skeleton key” for these desperate scenarios. We explore the neurochemistry of switching from the failed inhibitory (GABA) pathway to  ...