Achieving stable remission with maintenance electroconvulsive therapy in a patient with treatment-resistant schizophrenia

RATIONALE Up to one third of all schizophrenic patients are classified as having treatment-resistant schizophrenia (TRS). This subgroup faces remarkable medical and psychosocial damages, and pharmacotherapy is often limited due to nonresponse and/or side effects. Maintenance electroconvulsive therapy (M-ECT) might be effective in TRS. PATIENT CONCERNS We present a case of a 26-year-old male patient with a TRS. DIAGNOSES He received a treatment series of ECT sessions and a course of 24 M-ECTs. INTERVENTIONS The entire treatment was tolerated without significant side effects. OUTCOMES Moreover, the Psychotic Symptom Rating Scale (PSYRATS) scores for both positive and negative symptoms decreased and remained stable over the course of M-ECT. LESSONS Because of the remarkable improvement in the negative and positive symptom clusters, we propose systematic examinations in the field of M-ECT in TRS patients. These studies should integrate long-term outcome and tolerance measurements, gaining insight into the optimal duration of treatment for this indication.