Mutism is a common manifestation of catatonia, but mutism due to other forms of psychopathology and neurological disorders have
also been described. Although not common, long-standing mutism has also been a feature of non-catatonic schizophrenia and traditionally
responds less to conventional therapies. Case Report: We describe a rare case of paranoid schizophrenia presenting with continuous mutism
for about 4 years. This 26-year-old male had symptoms of schizophrenia without catatonia. After failed trial of adequate pharmacotherapy
and psychological intervention and considering his level of dysfunction, he was started on electroconvulsive therapy (ECT). To our surprise,
he improved with a single session of ECT while he was on concurrent pharmacotherapy. We also discuss the possible explanation for this
rapid effect of ECT in such clinical presentation. To our knowledge, this is the fi rst case of non-catatonic mutism of schizophrenia of
this long duration responding so promptly to ECT, although there are other reports as well in literature, but multiple ECT sessions were
applied in those cases. Conclusion: Non-catatonic mutism is perhaps presenting as a cultural variant in this part of the world and whenever
encountered, ECT should be an option. Further research should be carried out to validate this idea.