We describe the case of a 65-year-old woman with long-standing, atypical facial pain and fluctuating mental symptoms. A variety of psychiatric diagnoses were made over a period of nine years but no effective treatment was found. Ultimately, the patient was found to suffer from a psychotic depression indicating Cotard's syndrome. Two series of ECT were then given with temporary short remissions. Subsequently, continuation ECT was introduced. To our knowledge, continuation ECT in Cotard's syndrome is rarely, if ever, described in the literature.

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