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ECT for prolonged catatonia.

C Malur¹, E Pasol, A Francis

¹Department of Psychiatry and Behavioral Sciences, SUNY at Stony Brook, New York 11794, USA.

The Journal of ECT

|April 3, 2001

Summary

Electroconvulsive therapy (ECT) effectively treats prolonged catatonia, even with medical complications. This treatment may require numerous sessions, especially when gross cerebral pathology is present.

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Area of Science:

Neurology
Psychiatry

Background:

Electroconvulsive therapy (ECT) is established for acute catatonia.
Its efficacy in prolonged catatonia, particularly with medical comorbidities, remains less defined.

Observation:

Three cases of prolonged catatonia (4-14 weeks) with medical complications were treated with ECT.
Patients included those with neuroleptic-induced autonomic instability, lupus cerebritis, and neuroleptic malignant syndrome.

Findings:

Electroconvulsive therapy (ECT) led to resolution in all three cases, though treatment courses varied (15-20 sessions).
One patient with lupus cerebritis and cerebral lesions showed a less robust response.
Benzodiazepine treatment (lorazepam) provided minimal benefit prior to ECT.

Implications:

Electroconvulsive therapy (ECT) can be a viable treatment for prolonged catatonia with complex medical issues.
The number of ECT sessions may need to be higher in prolonged cases.
Pre-existing cerebral pathology might influence treatment response to ECT.

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