Successful treatment with electroconvulsive therapy in a terminally ill cancer patient with delusions and hallucinations: a case report

Abstract

Purpose: We report successful treatment of a patient with delusions and hallucinations by using electroconvulsive therapy (ECT) at a palliative care unit (PCU). Case Report: A female patient in her thirties was diagnosed with recurrent ascending colon cancer and metastatic lung cancer. On the 18th day after admission to our PCU, she developed severe delusions and hallucinations with catatonia. She was unable to take medicines orally because of obstruction of the digestive tract. Further, standard treatment using intravenous haloperidol was ineffective. We repeatedly evaluated her psychiatric and somatic status and administered ECT under general anesthesia (midazolam, propofol, and suxamethonium chloride). The decision to administer ECT was made by the members of a multidisciplinary team. On the 1st day of ECT, delusions and hallucinations were markedly reduced. These symptoms disappeared after 4 courses of ECT for 3 days, and she returned to normal clinical status without demonstrable side effects. The levels of serum creatine phosphokinase and electrolytes were in normal range. Conclusion: ECT is a highly effective treatment for psychiatric disorders and can be administered to a special population of patients (for example, pregnant women, elderly patients, patients resistant to treatment, and patients in emergency). Our experience indicates that ECT is an effective and relatively safe procedure of choice for terminally ill cancer patients. Palliat Care Res 2011;6 (1): 336-339