Electroconvulsive therapy for catatonia.

摘要

To the Editor: We applaud the excellent care described by Marc H. Zisselman, M.D., and Richard L. Jaffe, M.D., (1) in their Clinical Case Conference published in the February 2010 issue of the Journal. Their case presentation and discussion highlight important issues in the recognition and urgent, definitive treatment of catatonia in a young patient. We would like to suggest an alternative ECT treatment procedure when urgent/emergent situations, such as the one described, occur. Since the most effective ECT is indicated, stimulus dosing should be high and consideration should be given to inducing two seizures per ECT session (en bloc ECT) until clinical improvement is apparent (2). Although the authors commented that the initial stimulus setting of 20% of the device maximum was higher than would have been prescribed by the half-age method (3), this was still very conservative.