Paolo Girardi, Chiara Rapinesi, Ilaria Cuomo, Giorgio D. Kotzalidis, Antonio Del Casale, Daniele Serata, Sandra Campi, Matteo Caloro, Lavinia De Chiara, Stefano Maria Tamorri, Paola Scatena, Federica Caccia, Francesco Saverio Bersani, Paolo Carbonetti, Alessandro Vento, Giorgia Dimitri-Valente, Roberto Tatarelli, Claudio Fensore, Stefano Ferracuti, Gloria Angeletti

A young woman with bipolar I disorder and comorbid catatonia on enteral nutrition from several months, developed
a form of near-lethal catatonia with weight loss, pressure sores, muscle atrophy, electrolyte imbalance, and depression
of vital signs. A compulsory treatment was necessary, and informed consent was obtained from her mother for electroconvulsive
therapy (ECT). After 7 ECT sessions, the patient recovered and resumed feeding. ECT may save the life of a patient with
catatonia provided that legal obstacles are overcome. Clinicians should carefully evaluate patients with near-lethal catatonia,
taking into account the risk of pulmonary embolism or other fatal events. The medical-legal issues, which vary across state
regulations, should be addressed in detail to avoid unnecessary and potentially harmful delay in intervention.