Successful maintenance electroconvulsive therapy for more than seven years

We report on a patient with recurrent major depressive episodes with psychotic features who was successfully treated with maintenance electroconvulsive treatment (M-ECT) over a long period without the need for concurrent treatment with an antidepressant or mood stabilizer. She started ECT in 1996 and has received M-ECT for more than 7 years. To date (2005), she has received 244 treatments. After 5 admissions in nearly 4 years, involving 29 months in hospital, she has not needed any further psychiatric admission for 7 1/2 years since the start of the M-ECT. Her depression has been in complete remission for nearly 6 years, with the exception of one mild-to-moderate nonpsychotic depressive episode lasting for 2 months. The patient exhibited slight cognitive deficits but had no subjective complaints before ECT, and her cognitive deficits did not worsen after the initial ECT. Thus M-ECT does not appear to cause cognitive deterioration. M-ECT is being continued on the patient's request.