Skip to main content

Advertisement

SpringerLink
Log in

Case Report: Successful Use of the Combination of Electroconvulsive Therapy and Clozapine in Treating Treatment-Resistant Schizophrenia and Catatonia in an Adult with Intellectual Disability

  • Letter to the Editor
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

There is paucity of empirical data regarding the use of either clozapine or electroconvulsive therapy (ECT) in the acute phase and maintenance treatment of schizophrenia in adults with intellectual disability. Herein we report the successful acute and long-term remission of psychotic symptoms and catatonia with the combination of clozapine and ECT in a 26-year-old female with moderate ID and treatment-resistant schizophrenia. To our knowledge, this is the first case example of the successful use of the combination of bilateral, standard-pulse ECT and clozapine in both acute and long-term treatment of treatment-resistant schizophrenia and catatonia in an adult with ID. Our report adds further support to the emerging evidence regarding the efficacy and safety of this combination in treatment-resistant schizophrenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Ahuja, N. (2000). Organic catatonia: A review. Indian Journal of Psychiatry, 42(4), 327–346.

    PubMed  PubMed Central  Google Scholar 

  • Antonacci, D. J., & de Groot, C. M. (2000). Clozapine treatment in a population of adults with mental retardation. Journal of Clinical Psychiatry, 61(1), 22–25.

    Article  Google Scholar 

  • Ayub, M., Saeed, K., Munshi, T. A., & Naeem, F. (2015). Clozapine for psychotic disorders in adults with intellectual disabilities. Cochrane Database Systematic Reviews, CD010625. https://doi.org/10.1002/14651858.CD010625.pub2.

  • Bain, S. K., & Allin, J. D. (2005). Book review: Stanford-Binet intelligence scales, fifth edition. Journal of Psychoeducational Assessment, 23, 87–95.

    Article  Google Scholar 

  • Bush, G., Fink, M., Petrides, G., Dowling, F., & Francis, A. (1996). Catatonia. I. Rating scale and standardized examination. Acta Psychiatrica Scandinavica, 93(2), 129–136.

    Article  Google Scholar 

  • Chanpattana, W. (1999). Maintenance ECT in mentally retarded, treatment-resistant schizophrenic patients. Journal of ECT, 15(2), 150–153.

    PubMed  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

    Article  Google Scholar 

  • Gelenberg, A. J. (1976). The catatonic syndrome. Lancet, 1, 1339–1341.

    Article  Google Scholar 

  • Gladston, S., & Clarke, D. J. (2005). Clozapine treatment of psychosis associated with velo-cardio-facial syndrome: Benefits and risks. Journal of Intellectual Disability Research, 49(7), 567–570.

    Article  Google Scholar 

  • Koen, B. C., & Niehaus, D. J. H. (2008). Combining ECT and clozapine in the treatment of clozapine-refractory schizophrenia and schizoaffective disorder: A pilot study. South African Journal of Psychiatry, 14(4), 131–135.

    Article  Google Scholar 

  • Overall, J. E., & Gorham, D. R. (1962). The brief psychiatric rating scale. Psychological Reports, 10, 799–812.

    Article  Google Scholar 

  • Petrides, G., Malur, C., Braga, R. J., et al. (2015). Electroconvulsive therapy augmentation in clozapine resistant schizophrenia: A prospective, randomized study. American Journal of Psychiatry, 172(1), 52–58.

    Article  Google Scholar 

  • Reinblatt, S. P., Rifkin, A., & Freeman, J. (2004). The efficacy of ECT in adults with mental retardation experiencing psychiatric disorders. Journal of ECT, 20(4), 208–212.

    Article  Google Scholar 

  • Rust, J. O., & Wallace, M. A. (2004). Book review: Adaptive behvaiour assessment system-second edition. Journal of psychoeducational Assessment, 22, 367–373.

    Article  Google Scholar 

  • Smith, J. H., Smith, V. D., Philbrick, K. L., et al. (2012). Catatonic disorder due to a general medical or psychiatric condition. Journal of Neuropsychiatry and Clinical Neuroscience, 24(2), 198–207.

    Article  Google Scholar 

  • Thalayasingam, S., Alexander, R. T., & Singh, I. (2004). The use of clozapine in adults with intellectual disability. Journal of Intellectual Disability Research, 48(6), 572–579.

    Article  Google Scholar 

  • van Waarde, J. A., Stolker, J. J., & van der Mast, R. C. (2001). ECT in mental retardation: A review. Journal of ECT, 17(4), 236–243.

    Article  Google Scholar 

Download references

Funding

No funding received for this work.

Author information

Authors and Affiliations

  1. Adult Neurodevelopmental Services, Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 1001 Queen Street West, Unit 4, Toronto, ON, M6J 1H4, Canada

    Pushpal Desarkar, Daniel Blumberger & Zafiris Jeff Daskalakis

  2. Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada

    Pushpal Desarkar, Daniel Blumberger & Zafiris Jeff Daskalakis

Authors
  1. Pushpal Desarkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Blumberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zafiris Jeff Daskalakis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pushpal Desarkar.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Desarkar, P., Blumberger, D. & Daskalakis, Z.J. Case Report: Successful Use of the Combination of Electroconvulsive Therapy and Clozapine in Treating Treatment-Resistant Schizophrenia and Catatonia in an Adult with Intellectual Disability. J Autism Dev Disord 48, 3637–3640 (2018). https://doi.org/10.1007/s10803-018-3589-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-018-3589-7

Keywords

Search

Navigation