A case of rapid stabilization using electroconvulsive therapy (ECT) for a major
depressive disordered (MDD) patient with life-threatening low body mass index
(BMI) is reported. This case report focuses on a 55-year-old Malay housewife with
underlying hyperthyroidism in a euthyroid state who presented with MDD with
mood congruent psychotic features, which were precipitated by the death of her
husband. Her BMI was only 11 kg/m2
due to severe anorexia, and she was highly
suicidal. Peripheral total parenteral nutrition was started and ECT was commenced
for rapid stabilization on top of tablet escitalopram 15 mg nocte. Full remission was achieved after nine ECTs and steady healthy weight gain was achieved throughout
admission. The patient was discharged at BMI of 13 kg/m2
with good appetite. ECT
was safe for very low BMI MDD patient.