Improvement of cognition in a patient with Cotard's delusions and frontotemporal atrophy receiving electroconvulsive therapy (ECT) for depression.
A 69-year-old man presented with Cotard's delusions, insomnia, profound depression, amnesia, difficulty concentrating, and cognitive deficit after two different surgical interventions. Brain imaging showed frontotemporal-subcortical atrophy and lateral ventricular enlargement. He responded poorly to a combination of sertraline, amisulpride and mirtazapine, with modest benefit on insomnia, and developed hypotension. After 18 days he was switched to olanzapine and venlafaxine, but his cognition worsened. He underwent bilateral electroconvulsive therapy (ECT). His mood improved, cognitive performance increased and anxiety symptoms remitted. This improvement persisted through the one-month post-discharge follow-up and depression eventually remitted.
Fàzzari
Giuseppe
G
Spedali Civili Brescia, Azienda Ospedaliera, Presidio Ospedaliero di Montichiari, Servizio Psichiatrico Diagnosi e Cura-Unità Operativa di Psichiatria N. 23, Brescia, Italy.
Benzoni
Oliviero
O
Sangaletti
Alessio
A
Bonera
Francesca
F
Nassini
Stefano
S
Mazzarini
Lorenzo
L
Pacchiarotti
Isabella
I
Sani
Gabriele
G
Koukopoulos
Alexia Emilia
AE
Sanna
Livia
L
Gasparotti
Roberto
R
De Rossi
Pietro
P
Lazanio
Simone
S
Savoja
Valeria
V
Girardi
Paolo
P
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003702:Delusions / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D003704:Dementia / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D007839:Functional Laterality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D013577:Syndrome; D016896:Treatment Outcome
D000928:Antidepressive Agents; D014150:Antipsychotic Agents