Ultra-Brief Pulse Right Unilateral ECT Combined with Lorazepam to Sustain Catatonia Remission as a Continuation Treatment: A Case Report

Dana Wang and Arkadiy Stolyar

Department of Psychiatry, Harvard Medical School/VA Boston Healthcare System, Massachusetts, USA
Department of Geriatric Psychiatry, Harvard Medical School, Mclean Hospital, Massachusetts, USA

^*Correspondance to: Dana Wang 

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Abstract:

Objective and
Background: Catatonia can be a recurrent psychiatric condition that has severe complications especially in the elderly population; however, options to prevent recurrence are limited.Case Report: A 62 year old woman with a history of bipolar depression and catatonia relapsed after becoming non adherent with outpatient ECT follow up, despite the continued daily use of lorazepam and other psychotropic medications. Cessation of ECT maintenance resulted in catatonic recurrence secondary to bipolar depression within 1 month. The patient was subsequently rehospitalized and treated with ultra-brief pulse RUL ECT acutely, then tapered eventually to monthly as maintenance treatment. She has successfully remained in remission more than 6 months after discharge.Conclusion: Ultra-brief pulse RUL ECT is effective to prevent catatonia relapse and as a long-term maintenance treatment. It did not cause any apparent cognitive impairment in this elderly patient. Ultra-brief pulse RUL ECT can be considered as an acute and maintenance treatment option for catatonia in addition to lorazepam.

Keywords:

Catatonia; Bipolar depression; Ultra-brief pulse; Right unilateral;Electroconvulsive therapy; Continuation treatment

Cite the Article:

Wang D, Stolyar A. Ultra-Brief Pulse Right Unilateral ECT Combined with Lorazepam to Sustain Catatonia Remission as a Continuation Treatment: A Case Report. Ann Clin Case Rep. 2017; 2: 1321.