ECT To Treat Schizophrenia: New Case Report

Out on Pubmed, from clinicians in Connecticut, is this case report:

Late to respond, but early to relapse - An abnormal course of electroconvulsive therapy in treatment-resistant schizophrenia during times of COVID-19.

Qureshi H, Jain L.Psychiatry Res Case Rep. 2022 Dec;1(2):100052. doi: 10.1016/j.psycr.2022.100052. Epub 2022 Sep 19.PMID: 36188755 

The case is here.

And here:

Here is a well-intended publication that raises important questions about ECT treatment planning for patients with severe schizoaffective disorder or schizophrenia. The patient described is desperately ill and with a tragic life history. 

She ultimately got dramatically better, but the healthcare system was unable to provide an environment that could sustain the improvement.

The details of patient management here were clearly flawed, despite the good intent and the perseverance of the team to provide ECT.

It was a mistake to use ultrabrief-pulse RUL in such an urgently ill patient and to persevere for 14 treatments before changing to BL electrode placement (which got the patient well quickly).

Her rapid relapse could have been prevented with tapering of the course and continuation ECT. The time allotted by the court for treatment would have been much better used with BL treatment from the start, leaving enough time for a taper of the course.

This is an example of exaggerated fears of cognitive side effects totally sabotaging the clinical outcome.