title: Successful use of right unilateral ECT for catatonia: a case series.
abstract: Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.
authors.affiliation: From the *Department of Psychiatry, Washington University School of Medicine, St. Louis, MO and †BJC Behavioral Health, St. Louis, MO.
authors.forename: Pilar
authors.initials: P
authors.lastname: Cristancho
authors.forename: Delaina
authors.initials: D
authors.lastname: Jewkes
authors.forename: Thetsu
authors.initials: T
authors.lastname: Mon
authors.forename: Charles
authors.initials: C
authors.lastname: Conway
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D002389:Catatonia / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use; D008140:Lorazepam / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000523:psychology / Q000628:therapy; D008297:Male; D000068882:Paliperidone Palmitate; D011618:Psychotic Disorders / Q000150:complications / Q000628:therapy; D011743:Pyrimidines / Q000627:therapeutic use; D012560:Schizophrenia, Catatonic / Q000150:complications / Q000523:psychology / Q000628:therapy; D012640:Seizures / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D018757:GABA Modulators; D007555:Isoxazoles; D011743:Pyrimidines; D008140:Lorazepam; D000068882:Paliperidone Palmitate