ECT dilemma: should we start this treatment earlier?
Patients with HIV-infection are at increased risk of psychiatric illnesses, including psychosis. Psychiatric symptoms in HIV-positive subjects may be more severe than in the general population and include catatonic symptoms. Evidence shows that ECT should be the first line treatment for catatonia if pharmacotherapy with benzodiazepines has failed. However, critics of ECT still describe this procedure as “barbaric” and ineffective. Such views may impact practice and hinder the timely initiation of a potentially life-saving treatment. We present a case report of catatonia in an HIV-positive subject unrelated to infectious processes which was effectively treated with ECT.