Electroconvulsive therapy (ECT) with ketamine induction for catatonia in an HIV positive patient

South African Journal of Psychiatry

Field Value
Title Electroconvulsive therapy (ECT) with ketamine induction for catatonia in an HIV positive patient
Creator Nel, Yvette Bracken, Craig A.
Subject Psychiatry; Medicine; Anaesthetics ECT; case report; Ketamine; HIV; catatonia
Description Introduction: The successful use of ECT as treatment for catatonia, in the context of HIV (human immunodeficiency virus) infection, has been described previously. Ketamine has been used as an anaesthetic induction agent for ECT, although not considered the induction agent of choice. There are also case reports suggesting that ketamine may be an alternative treatment specifically for catatonia.Patient presentation: This case report describes the management of a female patient who presented with catatonia, evidenced by stupor, waxy flexibility, mutism, negativism, and stereotypy, as well as stage four HIV infection, with poor response to previous psychotherapeutic interventions.Management and outcome: We describe the course of management of this patient with ECT, following poor initial clinical response to ECT with propofol induction, the subsequent use of ketamine as an anaesthetic induction agent for ECT, with associated improvement in seizure quality, and good overall clinical response to ECT demonstrated thereafter.Conclusion and contributions: This case report suggests that ketamine may be a viable induction agent for ECT in this clinical setting.
Publisher AOSIS
Date 2023-01-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — case report
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajpsychiatry.v29i0.1944
Source South African Journal of Psychiatry; Vol 29 (2023); 4 pages 2078-6786 1608-9685
Language eng
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https://sajp.org.za/index.php/sajp/article/view/1944/2832 https://sajp.org.za/index.php/sajp/article/view/1944/2833 https://sajp.org.za/index.php/sajp/article/view/1944/2834 https://sajp.org.za/index.php/sajp/article/view/1944/2835
Coverage Africa; South Africa, Gauteng; Johannesburg 2019 female, mid 30s
Rights Copyright (c) 2023 Yvette Nel, Craig A. Bracken https://creativecommons.org/licenses/by/4.0