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Int Psychogeriatr. 2009 Jun;21(3):600-3. doi: 10.1017/S1041610209008990. Epub 2009 Apr 16.

Improvement of cognition in a patient with Cotard's delusions and frontotemporal atrophy receiving electroconvulsive therapy (ECT) for depression.

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Spedali Civili Brescia, Azienda Ospedaliera, Presidio Ospedaliero di Montichiari, Servizio Psichiatrico Diagnosi e Cura-Unità Operativa di Psichiatria N. 23, Brescia, Italy.


A 69-year-old man presented with Cotard's delusions, insomnia, profound depression, amnesia, difficulty concentrating, and cognitive deficit after two different surgical interventions. Brain imaging showed frontotemporal-subcortical atrophy and lateral ventricular enlargement. He responded poorly to a combination of sertraline, amisulpride and mirtazapine, with modest benefit on insomnia, and developed hypotension. After 18 days he was switched to olanzapine and venlafaxine, but his cognition worsened. He underwent bilateral electroconvulsive therapy (ECT). His mood improved, cognitive performance increased and anxiety symptoms remitted. This improvement persisted through the one-month post-discharge follow-up and depression eventually remitted.

[Indexed for MEDLINE]

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