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Updated: Feb 16, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Achieving stable remission with maintenance electroconvulsive therapy in a patient with treatment-resistant
Sebastian Moeller1, Neele Kalkwarf, Caroline Lücke
1Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy-University Hospital Geriatric Psychiatry ECT Unit, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany.
Rationale:
Up to one third of all schizophrenic patients are classified as having treatment-resistant schizophrenia (TRS). This subgroup faces remarkable medical and psychosocial damages, and pharmacotherapy is often limited due to nonresponse and/or side effects. Maintenance electroconvulsive therapy (M-ECT) might be effective in TRS.
Patient Concerns:
We present a case of a 26-year-old male patient with a TRS.
Diagnoses:
He received a treatment series of ECT sessions and a course of 24 M-ECTs.
Interventions:
The entire treatment was tolerated without significant side effects.
Outcomes:
Moreover, the Psychotic Symptom Rating Scale (PSYRATS) scores for both positive and negative symptoms decreased and remained stable over the course of M-ECT.
Lessons:
Because of the remarkable improvement in the negative and positive symptom clusters, we propose systematic examinations in the field of M-ECT in TRS patients. These studies should integrate long-term outcome and tolerance measurements, gaining insight into the optimal duration of treatment for this indication.
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