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In this case report, a 78-year-old woman, who had a cochlear implant, was treated with electroconvulsive therapy (ECT). The patient suffered from major depressive disorder with psychotic features. Normally, ECT is not recommended for patients with cochlear implants because of a potential risk of damage to the patient or the implant, but in this case ECT was performed due to life-threatening conditions. The treatment was effective and well-tolerated, and there was no damage to the cochlear implant.