Concurrent administration of clozapine and ECT: A successful therapeutic strategy for a patient with treatment-resistant schizophrenia

A male patient with a 4-year history of schizophrenic disorder, treated in the past with several conventional neuroleptics, atypical antipsychotics, as well as adjunctive therapies, was hospitalized because of treatment resistance/intolerance to pharmacotherapy. During 60 weeks of hospitalization, the patient was treated with conventional neuroleptics or clozapine monotherapy and with concurrent bilateral electroconvulsive therapy (ECT). The patient showed inadequate response to conventional neuroleptics or clozapine without ECT. Concurrent administration of pimozide and ECT resulted in a brief period of improvement. However, concurrent administration of clozapine and ECT resulted in substantial improvement. Our observation suggests that combination treatment with clozapine and ECT can be safe and effective.