Continuation/maintenance electroconvulsive therapy (c/m ECT) is a maintenance treatment to prevent the relapse of treatment-resistant psychiatric disorders. Its therapeutic efficacy has been recently demonstrated, but the clinical guidelines for the interval and duration of c/m ECT are lacking, and evidence on the adverse events is insufficient. In addition, there are few studies on clinical and functional outcomes after the termination of c/m ECT. In this study, we report two cases in which we followed the clinical course after the termination of c/m ECT. c/m ECT was terminated without adverse effects in all two cases, but one patient relapsed and restarted c/m ECT. However, improvement in clinical and functional outcomes was observed without adverse events such as long-term cognitive decline. Thus, appropriate maintenance treatments, including the restart of c/m ECT, may be useful in improving long-term clinical and functional outcomes, whereas the relapse risk after termination of c/m ECT is relatively high. Further evidence is required to establish a treatment plan, exit strategy, and subsequent maintenance treatment.
 Authors' abstract