Chung In Won, Kim Hye Sung, Kim Jung Hyun, Jang Jin Hyeok, Kim Yong Sik
Department of Psychiatry, Dongguk University International Hospital, Goyang, Korea.
Institute of Clinical Psychopharmacology, Dongguk University College of Medicine, Goyang, Korea.
Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):170-173. doi: 10.9758/cpn.2021.19.1.170.
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.
一名32岁患有精神分裂症且伴有持续性幻听的女性，幻听导致其持续产生自杀念头并陷入抑郁。她接受了一个疗程的急性电休克治疗（ECT），随后在氯氮平基础上加用维持性电休克治疗（M-ECT），持续了7年。尽管ECT和氯氮平最初使总体精神病理学症状和幻听略有减轻，但她的幻听和自杀念头在主观上并未减少。在进行3年的M-ECT治疗后，她的幻听急剧减少，此后两年病情持续改善。总共进行了91次ECT治疗。氯氮平的每日剂量从325毫克降至200毫克，血浆水平仍高于350纳克/毫升；未出现明显的认知副作用。总之，我们报告了一例在长期M-ECT治疗3年后持续性幻听突然大幅减少的病例。
