Institutional members access full text with Ovid®

Share this article on:

Successful Use of Right Unilateral ECT for Catatonia: A Case Series

Cristancho, Pilar MD*; Jewkes, Delaina MD; Mon, Thetsu MD, PhD*; Conway, Charles MD*

doi: 10.1097/YCT.0b013e31829a01d3
Case Reports

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.

From the *Department of Psychiatry, Washington University School of Medicine, St. Louis, MO and †BJC Behavioral Health, St. Louis, MO.

Received for publication March 19, 2013; accepted April 26, 2013.

Reprints: Pilar Cristancho, MD, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO (e-mail: cristanp@psychiatry.wustl.edu).

The authors have no conflicts of interest or financial disclosures to report.

© 2014 by Lippincott Williams & Wilkins