Electroconvulsive Therapy for the Treatment of Protracted Resistant Agitated Psychosis With Comorbid Delirium in the...

Delirium is a common and debilitating condition in the intensive care unit (ICU), leading to prolonged hospital stays, increased mortality, and significant morbidity. While nonpharmacologic interventions are typically the first line of treatment, pharmacologic approaches such as antipsychotics are often used to manage agitation, with variable efficacy. This case report describes a patient with agitated psychosis with comorbid delirium in the ICU, who failed to respond to multiple trials of antipsychotic medications and experienced a prolonged ICU stay. Electroconvulsive therapy (ECT) was initiated, with subsequent improvement in the patient's symptoms, including the resolution of agitation and delirium. This case underscores the need for early consideration of ECT in treatment-resistant agitated psychosis with comorbid delirium and highlights the potential benefits of this approach, particularly in patients with complicated or multifactorial presentations.