Electroconvulsive therapy for major depressive disorder in a patient with a permanent skull defect: a case report

Electroconvulsive therapy (ECT) is an effective and safe treatment method for a variety of psychiatric disorders, including major depressive disorder. Although there is no absolute contraindication to ECT, clinicians often hesitate to apply this method to patients with a skull defect. We report a case of ECT performed on a major depressive disorder patient with an open wound after craniectomy. We summarize successful ECT cases of patients with a permanent skull defect and discuss various factors that may influence ECT outcomes in patients with a skull defect, including electrode placement, benzodiazepines, and anticonvulsants.