Title: Clinical profile of patients receiving Continuation Electro Convulsive Therapy: a 10 year retrospective study

BACKGROUND: There is lack of data on use of Continuation Electro Convulsive Therapy (C-ECT) from India. AIM: This study aimed to evaluate the clinical profile and outcome of patients with severe mental illness receiving C-ECT. METHOD: ECT register was used to identify patients receiving C-ECT (ECT after completion of acute course, to maintain remission/ prevent relapse) during 2011 to 2021. Sociodemographic, clinical and outcome details were extracted from treatment records. Sixty C-ECT courses were identified, used in 49 patients. RESULTS: Majority were male (58.3%), single (56.7%), unemployed (66.7%), belonged to Hindu religion (70%), middle socioeconomic status (91.7%) and urban background (66.7%). Mean age at starting of ECT was around 40 years. Commonest diagnosis was schizophrenia (75%) followed by recurrent depressive disorder (18.3%). Commonest indication was persistent psychotic symptoms despite multiple antipsychotic trials (3.33±1.37), including clozapine. They received a mean of 22.62±8.02 ECTs, of which 9.93±4.41 were acute phase and 12.68±6.52 were for continuation treatment. Majority (66.7%) of them received 4 C-ECTs in the first month, followed by 2 more in the next month. As symptoms worsened with lower frequencies, 16 patients received weekly ECTs during the second month too. CGI-severity scores decreased from 6.50±0.60 to 3.80±0.75 at the end of C-ECT course. Majority of them maintained improvement gained during acute phase or showed further improvement with C-ECT with ongoing pharmacotherapy as rated on appropriate scales. CONCLUSION: C-ECT is considered only in small proportion of patients but is effective in maintaining benefits gained during acute course of ECT and preventing relapse.