The use of electroconvulsive therapy and general anaesthesia in catatonic schizophrenia complicated by clozapine - induced pancytopenia - case report.

Catatonic schizophrenia is characterized with at least two of the following: catalepsy or stupor, excessive motor activity; extreme negativism or mutism; peculiarities of voluntary movement as evidenced by posturing, stereotyped movements, prominent mannerisms, or prominent grimacing; echolalia or echopraxia (American Psychiatric Association 1994). Electroconvulsive therapy (ECT) is widely used and shown to be effective and safe in patients with catatonic schizophrenia (American Psychiatric Association 2001). However, to our knowledge no case of ECT in catatonic schizophrenia complicated with pancytopenia due to clozapine sensitisation has been reported. Pancytopenia is defined as an disorder in which all three major formed elements of blood (red blood cells, white blood cells and platelets) are decreased in number (Istiaq et al. 2004).