Resolution of Persistent Auditory Verbal Hallucinations after Long-term Electroconvulsive Therapy Maintenance: A Case Report of a Patient with Clozapine-resistant Schizophrenia
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A 32-year-old woman with schizophrenia and persistent auditory verbal hallucinations (AVHs), which caused continuous suicidal thoughts and depression, was treated with electroconvulsive therapy (ECT) of an acute course followed by maintenance ECT (M-ECT) augmented onto clozapine for 7 years. Although the general psychopathology and AVHs initially reduced slightly with ECT and clozapine, her AVHs and suicidal thoughts did not decrease subjectively. When 3 years of M-ECT, her voices declined sharply, and improvement was maintained for 2 years thereafter. A total 91 ECT sessions were performed. The daily clozapine dose was decreased from 325 to 200 mg and plasma levels remained higher than 350 ng/ml; there were no noticeable cognitive side effects. In summary, we report a case showing a sudden sharp reduction in persistent AVHs after 3 years of long-term M-ECT.
Abstract
A 32-year-old woman with schizophrenia and persistent auditory verbal hallucinations (AVHs), which caused continuous suicidal thoughts and depression, was treated with electroconvulsive therapy (ECT) of an acute course followed by maintenance ECT (M-ECT) augmented onto clozapine for 7 years. Although the general psychopathology and AVHs initially reduced slightly with ECT and clozapine, her AVHs and suicidal thoughts did not decrease subjectively. When 3 years of M-ECT, her voices declined sharply, and improvement was maintained for 2 years thereafter. A total 91 ECT sessions were performed. The daily clozapine dose was decreased from 325 to 200 mg and plasma levels remained higher than 350 ng/ml; there were no noticeable cognitive side effects. In summary, we report a case showing a sudden sharp reduction in persistent AVHs after 3 years of long-term M-ECT.
참고문헌 (23)
- Shergill SS, "Auditory hallucinations : a review of psychological treatments", Schizophr Res, 32, pp.137~150 (1998)
- In Won Chung, "Long-Term Changes in Self-Report Auditory Verbal Hallucinations in Patients with Schizophrenia Using Clozapine", PSYCHIATRY INVESTIGATION, 16(5), pp.403~406 (2019), 대한신경정신의학회[DOI]
- Kim SH, "Differences between self-reported and clinician-rated evaluations of 1-year changes in auditory verbal hallucinations among schizophrenia patients", Prog Neuropsychopharmacol Biol Psychiatry, 95, pp.109671~ (2019)
- Meltzer HY, "Treatment of the neuroleptic-nonresponsive schizophrenic patient", Schizophr Bull, 18, pp.515~542 (1992)
- González JC, "Persistent auditory hallucinations", Psychopathology, 39, pp.120~125 (2006)
- Chang JS, "Stabilization of the internal structure of persistent auditory verbal hallucinations in schizophrenia", Aust N Z J Psychiatry, 43, pp.244~251 (2009)
- Sommer IE, "The treatment of hallucinations in schizophrenia spectrum disorders", Schizophr Bull, 38, pp.704~714 (2012)
- Hor K, "Suicide and schizophrenia : a systematic review of rates and risk factors", J Psychopharmacol, 24(4Suppl), pp.81~90 (2010)
- Gallagher AG, "The effects of varying information content and speaking aloud on auditory hallucinations", Br J Med Psychol, 68, pp.143~155 (1995)
- Honings S, "Psychotic experiences and risk of violence perpetration and arrest in the general population : a prospective study", PLoS One, 11, pp.e0159023~ (2016)
- Petrides G, "Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia : a prospective, randomized study", Am J Psychiatry, 172, pp.52~58 (2015)
- 김혜성, "Effectiveness of Electroconvulsive Therapy Augmentation on Clozapine-Resistant Schizophrenia", PSYCHIATRY INVESTIGATION, 14(1), pp.58~62 (2017), 대한신경정신의학회[DOI]
- Sanghani SN, "Electroconvulsive therapy(ECT)in schizophrenia : a review of recent literature", Curr Opin Psychiatry, 31, pp.213~222 (2018)
- Youn T, "Long-term clinical efficacy of maintenance electroconvulsive therapy in patients with treatment-resistant schizophrenia on clozapine", Psychiatry Res, 273, pp.759~766 (2019)
- Pandarakalam JP, "Pharmacological and non-pharmacological interventions for persistent auditory hallucinations in schizophrenia", BJMP, 9, pp.a914~ (2016)
- Dellazizzo L, "Avatar therapy for persistent auditory verbal hallucinations in an ultra-resistant schizophrenia patient : a case report", Front Psychiatry, 9, pp.131~ (2018)
- Kirov G, "Four years of successful maintenance electroconvulsive therapy", J ECT, 25, pp.219~220 (2009)
- Berg JE, "Intractable schizo-affective disorder successfully treated with electroconvulsive treatment over six years", Ment Illn, 4, pp.e20~ (2012)
- Jung Hyun Kim, "Combination of Electroconvulsive Therapy and Clozapine in Treatment-Resistant Schizophrenia", PSYCHIATRY INVESTIGATION, 15(8), pp.829~835 (2018), 대한신경정신의학회[DOI]
- Bailine SH, "Maintenance electroconvulsive therapy is not acute electroconvulsive therapy", J ECT, 35, pp.1~2 (2019)
- Ward HB, "Maintenance ECT in schizophrenia : a systematic review", Psychiatry Res, 264, pp.131~142 (2018)
- Iancu I, "Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions : characteristics, indications, and results", Neuropsychiatr Dis Treat, 11, pp.853~862 (2015)
- Kellner CH, "Electrode placement in maintenance electroconvulsive therapy", Convuls Ther, 7, pp.61~62 (1991)
