Five female patients with chronic schizophrenia and schizoaffective disorder received electroconvulsive therapy (ECT). Patients were 58 to 74 years old when ECT began. Three patients followed the acute course of ECT with a course of maintenance ECT. Four patients were considered treatment-resistant to medication. One patient objected to any use of medication and opted for ECT when she became psychotic. Four patients received concurrent antipsychotic medication during and after the course of ECT. All five patients experienced improvement in their psychosis.