Case Reports: Clozapine for the Treatment of Catatonia in Autism Spectrum Disorder.

Doctors wrote up two teens with autism who became mute, stiff, and stopped eating.

Both had tried benzodiazepines and therapy with no luck. The team started the antipsychotic clozapine and watched for change.

This is a case series, so there was no control group—just careful notes on two real clients.

Both teens woke up. They began talking, eating, and moving again after clozapine doses were slowly raised.

Symptoms stayed down while the drug continued, suggesting clozapine can break catatonia when usual meds fail.

Walley et al. (2005) reported one autistic teen who snapped out of catatonia with ECT. The new cases show clozapine may offer a less-invasive rescue option.

Hasan et al. (2025) mapped six catatonia symptom clusters in autism. Their review includes odd tics, appetite loss, and self-injury—signs the two teens also showed—so the cases line up with the wider picture.

Nyrenius et al. (2025) scoured 17 papers and found treatment results “highly variable.” These two clear wins add a rare success story to that messy pile.

If your client with autism suddenly stops talking, eating, or moving, think catatonia first, not just “behavior.” Ask the psychiatrist about clozapine when standard lorazepam trials flop. Track baseline movement, speech, and mealtime data so you can show any drug effect in team reports.