Sharmilla Kanagasundram, Ishwary Damodaran, L. Pei, Tan Chow Hock
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Maintenance Electroconvulsive Therapy Meeting Unmet Needs of Antipsychotics in Older Patients: A Case Report
This case report highlights problems encountered by psychiatrists when treating a 68-year-old female patient
who presented with a first episode of psychosis. She suffered from constipation, an anticholinergic side
effect of quetiapine and both anticholinergic and extrapyramidal side effects of olanzapine. Finally, she was
able to tolerate a combination of two pharmacologically different antipsychotics namely olanzapine and
aripiprazole combined with a course of ECT followed by maintenance ECT. The authors would like to
highlight maintenance ECT as part of the solution to patients who find it difficult to tolerate antipsychotics.
Especially when only low doses of antipsychotics can be tolerated by the patient.
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