Maintenance Electroconvulsive Therapy in Catatonia: Clinical Profiles From a Case Series

Area of Science:

• Psychiatry
• Neurology
• Clinical Therapeutics

Background:

• Catatonia is a severe neuropsychiatric syndrome often requiring intensive treatment.
• Electroconvulsive therapy (ECT) is effective for acute catatonia, but relapse prevention strategies are crucial.

Purpose of the Study:

• To describe the clinical characteristics and treatment outcomes of patients with catatonia receiving maintenance electroconvulsive therapy (mECT).
• To evaluate the safety and tolerability of mECT in preventing catatonia relapse.

Main Methods:

• A descriptive analysis of 6 patients with catatonia treated with mECT between September 2020 and September 2022.
• Patients included those with schizophrenia and major depressive disorder, assessed for response and relapse after acute ECT.

Main Results:

• Four out of six patients achieved complete symptomatic remission after acute ECT.
• Maintenance ECT (mECT) was initiated due to high relapse risk, with a mean session frequency of 9.83 days.
• Two-thirds of patients received concurrent clozapine treatment; schizophrenia patients required more frequent mECT than the patient with depression.

Conclusions:

• Maintenance ECT is a safe and effective strategy for relapse prevention in severe catatonia post-acute ECT stabilization.
• Further research is necessary to establish optimal clinical guidelines for mECT application in catatonia.