Response to electroconvulsive therapy in patients with autism spectrum disorder and intractable behaviours associated with symptoms of catatonia

Author(s)
Sreedharan Greetha Sajith, Siew Fai Liew and Phern Chern Tor

Abstract

Background 

There are several reports of electroconvulsive therapy (ECT) used in autism spectrum disorder (ASD) in the context of catatonic symptoms. We describe response to ECT in two adults with ASD and intellectual disability with intractable aggression and self-injurious behaviors associated with catatonic symptoms who had not responded to standard interventions.

Method 

Unilateral ECT at a frequency of 3 times a week was given followed by weekly maintenance ECT.

Results 

Patients' catatonic symptoms included episodes of agitation and echophenomena. Electroconvulsive therapy resulted in significant improvement in their behavior problems but 1 patient relapsed when the ECT was discontinued or frequency of treatment reduced. The second patient required 2 courses of ECT before improvement which was maintained on weekly ECT.

Conclusions 

Electroconvulsive therapy could be a potentially beneficial intervention in patients with ASD and severe challenging behaviors associated with catatonic symptoms including agitated or excited forms of catatonia.