Multiple-Monitored Electroconvulsive Therapy (MMECT) - does it really just belong in psychiatry's past? A case report

Electroconvulsive therapy has been a method used in psychiatry since 1938 and despite its rather turbulent history, it is still the most effective method of treating severe mental disorders. Despite its high efficiency and good safety profile, patients with catatonia usually require a large number of treatments. It entails a long hospitalization time and the necessity to repeatedly induce general anesthesia. In 1966, Blachly proposed to induce more than one seizure during a single anesthesia. According to this method, the patient was to be constantly monitored (ECG, EEG) during a series of electroconvulsions, which consisted of two to even eight treatments. For simplicity, the method is called multiple-monitored ECT (MMECT). The work is based on the medical history of a patient diagnosed with catatonic schizophrenia. Due to the insufficient effect of single treatments, we decided to use the MMECT method, which was performed in series of three treatments, twice a week. Thanks to the therapy, catatonic symptoms remitted. Studies in various patient populations have shown that MMECT reduces hospitalization time, the duration of acute symptoms, and the patient's total exposure to anesthetics and muscle relaxants. As the above case shows, MMECT can potentially be considered as a safe treatment alternative in patients that require a large number of treatments, resistant to standard forms of therapy.