Abstract
Catatonia is a severe but often underrecognized neuropsychiatric condition in adolescents. We present the case of a 16-year-old girl with early-onset schizophrenia who developed acute catatonic symptoms during a relapse following risperidone reintroduction. The clinical presentation raised a diagnostic dilemma with neuroleptic malignant syndrome (NMS). A lorazepam trial led to partial improvement, but symptom resolution occurred only after adding low-dose aripiprazole. This case underscores the importance of early identification of catatonia in adolescents, careful differentiation from NMS, and the potential benefit of combined lorazepam and aripiprazole treatment in catatonic schizophrenia.