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Maintenance Electroconvulsive Therapy for Depression With Catatonia in a Young Woman With Down Syndrome

Torr, Jennifer MBBS, FRANZCP, MMed (Psychiatry)*; D’Abrera, Juan Carlos BSc, MBBS, MMed, (Psychiatry), FRANZCP

doi: 10.1097/YCT.0000000000000116
Case Report

Objectives: To describe and discuss the use of maintenance electroconvulsive therapy (ECT) in a young woman with Down syndrome and depression with catatonia.

Methods: Clinical case report.

Results: A 23-year-old woman with Down syndrome (mosaic type) and a 4-year history of depressed mood triggered by adverse life events presented with mutism, psychomotor retardation, and compromised oral intake. Multiple trials of antidepressant medications were either ineffective or complicated by adverse reactions. She improved rapidly with a course of bilateral ECT but required maintenance ECT to sustain recovery. A series of premorbid, morbid, and post-treatment drawings by the young woman highlight the efficacy of treatment.

Conclusion: Electroconvulsive therapy was found to be a safe and effective treatment for life-threatening mental illness in a young woman with Down syndrome who had failed multiple trials of antidepressant medications. This case highlights the importance of considering catatonia as a diagnosis in persons with Down syndrome and the effectiveness of electroconvulsive treatment.

From the *Centre for Developmental Disability Health Victoria, Monash University and †Mental Health Intensive Care Unit, Prince of Wales Hospital, Randwick, NSW, Australia.

Received for publication June 18, 2013; accepted January 21, 2014.

Reprints: Jennifer Torr, MBBS, FRANZCP, MMed(Psychiatry), Centre for Developmental Health Victoria, Monash University, Building One, Omnico Business Centre, 270 Ferntree Gully Rd, Notting Hill, Victoria, Australia, 3168 (e-mail:

Centre for Developmental Disability Health Victoria, Monash University receives core funding from the Victorian State Goverment Department of Human Services

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

© 2014 by Lippincott Williams & Wilkins