summary  A case study of a patient with lethal catatonia is used as a basis for reviewing the differential diagnosis and the usefulness of antipsychotics in the treatment of this disorder. The literature on the subject of catatonia and lethal catatonia relates mainly to treatment with classic antipsychotics and shows that this group of drugs may aggravate rather than improve the condition of patients with these disorders. There is a lack of literature on the use of atypical antipsychotics and results are inconclusive. Current practice is to start treating lethal catatonia with high doses of benzodiazepines; this is followed by electroconvulsive therapy if the patient shows no improvement within the first few days.