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COTARD HAS LIFTED WITH SHOCK THERAPY AND MEDICINE
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OKAY BACK FROM THE PSYCH WARD 🛏️
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A MAN WHO REFUSED SOLID FOOD AND RECEIVED ECT ⚡
A Case Report From Turkey Describes A Man Known As Mr. G
Mr. G Was A 27 Year Old Single Man
His Gastroenterologist Referred Him For His Psychiatric Symptoms
The Report Lists A Delusion That He Had No Stomach
Another Was That His Stomach Had Connected With His Heart
In His Delusion The Heart Had No Beat
His Symptoms Included Refusal To Eat Solid Food
In 1 Month His Weight Fell From 75 To 63 Kilograms
Doctors Diagnosed Schizophreniform Disorder
He Was Prescribed Haloperidol
With Antipsychotics He Started To Eat Some Solid Food
Doctors Later Replaced Haloperidol With Quetiapine
After 2 Weeks Of Quetiapine His Somatic Delusions Continued
Next Doctors Referred Him For A Course Of ECT
ECT Is Short For Electroconvulsive Therapy
One Article Says ECT Was Formerly Called Shock Therapy
It Describes ECT As A Seizure Induced By Electric Stimulation
His Treatments Were Performed Under General Anesthesia
He Received 12 Bilateral ECT Treatments At 3 Per Week
After The First Week Of ECT He Showed Improvement
He Was Back To His Premorbid Status After 12 Treatments
A Follow Up At 4 Months Found Him Still In Remission
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HOW STRONG THE ECT EVIDENCE IS 📋
The Authors Of Mr. G's Paper Wrote A Conclusion About ECT
Their Conclusion Is That ECT Could Be The First Line Therapy
They Limit That To Cotard With Psychotic Symptoms
Their Discussion Cites Earlier Findings Of ECT Advantages
A 2016 Case Report From Brazil Also Discusses Treatment Options
Its Authors Say Cotard Is Rare
They Say It Is Not Clear Which Treatment Is The First Choice
In Their Words ECT Has Been Preferred In Several Case Reports
That Preference Is Possibly Justified In Their View
The Reasons Given Are Severity And A Generally High Suicide Risk
A Case Report On A 53 Year Old Woman Called Ms. L Discusses ECT
Its Authors Cite Earlier Findings Of ECT Helping
Those Findings Involved Patients Whose Medication Had Failed
A UK Case Report Describes A 59 Year Old Woman Given ECT
She Received A Course Of Twelve ECTs
Her Nihilistic Delusions Had Resolved After That Course
Each Of These Papers Describes A Single Patient
Mayo Clinic Authors Say Most Published Literature Is Case Reports
So These ECT Findings Come From Individual Patients
One Of Those Papers Describes A Recovery Without ECT
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A RECOVERY WITHOUT AN ECT MACHINE 🌱
The Brazil Report Describes A 31 Year Old Man
Doctors Examined Him In The Psychiatric Emergency Sector
He Presented With Insomnia And Refusal Of Food
The Report Also Lists A Suicide Attempt
He Reported That His Organs Were Destroyed
In His Words He Was Hollow Inside
He Also Called Himself Rotten And Smelly Flesh
Cotard Was Diagnosed Secondary To A Serious Depressive Disorder
That Depressive Disorder Came With Psychotic Symptoms
His Hospital Did Not Have An ECT Machine
The Authors Add That ECT Is Not Always Easy To Get In Brazil
ECT Use Is Not Financed By The Public Service There
Doctors Prescribed Imipramine Together With Risperidone
About 60 Days Later He Was Released Asymptomatic
Their Report Says Medication Is Also Described As Successful
Its Authors Write That Treatment Should Target The Underlying Cause
The Authors Say Older Psychotropic Drugs Gave Success Here
Ms. L Was Also Treated With Medication
Over One Month She Showed Improvement On Medicines
Her Authors Write That She Responded Well To Medications
