Abstract
This case report highlights problems encountered by psychiatrists when treating a 68-year-old female patient who presented with a first episode of psychosis. She suffered from constipation, an anticholinergic side effect of quetiapine and both anticholinergic and extrapyramidal side effects of olanzapine. Finally, she was able to tolerate a combination of two pharmacologically different antipsychotics namely olanzapine and aripiprazole combined with a course of ECT followed by maintenance ECT. The authors would like to highlight maintenance ECT as part of the solution to patients who find it difficult to tolerate antipsychotics. Especially when only low doses of antipsychotics can be tolerated by the patient.
Highlights
Antipsychotics are associated with various side effects as they act on multiple receptors [1]
When it comes to treating elderly patients who may need antipsychotics, we need to exercise caution as many patients may have comorbid conditions, be on concomitant medications and possibly have reduced ability to clear medications from their body which is a natural accompaniment of advancing age [2]
The main focus of this case report was to highlight the benefits of electroconvulsive therapy (ECT) and M- ECT in elderly patients who are unable to tolerate emergent side effects because of a higher dose of antipsychotics
Summary
Antipsychotics are associated with various side effects as they act on multiple receptors [1]. This case report highlights problems encountered by psychiatrists when treating a 68-year-old female patient who presented with a first episode of psychosis. She was able to tolerate a combination of two pharmacologically different antipsychotics namely olanzapine and aripiprazole combined with a course of ECT followed by maintenance ECT. The authors would like to highlight maintenance ECT as part of the solution to patients who find it difficult to tolerate antipsychotics.
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