title: A case of deep venous thrombosis following protracted catatonic immobility recovered with electroconvulsive therapy: the relevance for an early intervention.
abstract: Catatonic patients often experience prolonged inactivity and dehydration, thus being prone to venous stasis leading to life-threatening thrombosis and pulmonary embolism (PE). When this occurs, the prescription of electroconvulsive therapy (ECT), actually irreplaceable in most life-threatening cases, remains controversial essentially due to an increased risk for PE and cerebral haemorrhage, with timing clinical decisions being as crucial as difficult to take. We report the case of a catatonic patient affected by malnutrition, deep venous thrombosis, severe pressure ulcers and septic syndrome resulting from previous untimely management, successfully treated with 16 well-tolerated ECT applications upon intensive supportive care. Although anecdotal, cases like this remind the relevance of early ECT to reduce the risk for potentially life-threatening complications due to prolonged catatonic inactivity, especially to those clinicians substantially disregarding this practice.
authors.affiliation: Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Italy. pmedda@psico.med.unipi.it
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Medda
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.forename: Sara
authors.initials: S
authors.lastname: Fratta
authors.forename: Antonio
authors.initials: A
authors.lastname: Callari
authors.forename: Valerio
authors.initials: V
authors.lastname: Manzo
authors.forename: Benedetta
authors.initials: B
authors.lastname: Ciaponi
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
mesh_terms: D000328:Adult; D002389:Catatonia / Q000150:complications* / Q000628:therapy*; D061345:Early Medical Intervention; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D020246:Venous Thrombosis / Q000209:etiology*