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Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

Published online by Cambridge University Press:  24 June 2014

Magdalena Romanowicz ,
Bruce Sutor  and
Christopher Sola
Magdalena Romanowicz
Affiliation:
Department of Psychiatry and Psychology, Stanford University, Stanford, CA, USA
Bruce Sutor*
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
Christopher Sola
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
*
Bruce Sutor, MD, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA. Tel: +507 255 2326; Fax: +507 284 3933; E-mail: sutor.bruce@mayo.edu
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Extract

Introduction: Depressive syndromes are common following cerebrovascular accident (CVA) and many patients do not respond to pharmacotherapy. Electroconvulsive therapy (ECT) is a safe and effective treatment for mood disorders arising with many comorbid medical conditions. In this paper, we describe the successful treatment of post-CVA depression with ECT.

Methods: Retrospective chart review of 24 patients hospitalised for depression on an in-patient Medical Psychiatry unit between 2000 and 2010. Medical, neurologic and psychiatric histories, physical examination findings, results of laboratory, imaging and neurophysiologic investigations and treatment response with medications and ECT were recorded.

Results: Twenty patients (83%) showed a positive response to treatment with ECT. None had worsening of depression after the ECT or experienced exacerbation of post-stroke neurological deficits. Three patients suffered from minor complications of ECT (prolonged confusion or short-term memory problems).

Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit.

Keywords

affective disorderantidepressantspsychiatric disorderstreatment resistance
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 4 , August 2012 , pp. 226 - 229
Copyright
Copyright © Cambridge University Press 2011

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References

1.Robinson, RG.Neuropsychiatric consequences of stroke. Annu Rev Med 1997;48:217–229.CrossRefGoogle ScholarPubMed
2.Paranthaman, R, Baldwin, RC.Treatment of psychiatric syndromes due to cerebrovascular disease. Int Rev Psychiatry 2006;18:453–470.CrossRefGoogle ScholarPubMed
3.Nuttall, GA, Bowersox, MR, Douglass, SB.Morbidity and mortality in the use of electroconvulsive therapy. J ECT 2004;20:237–241.CrossRefGoogle ScholarPubMed
4.Rasmussen, KG, Perry, CL, Sutor, B, Moore, KM.ECT in patients with intracranial masses. J Neuropsychiatry Clin Neurosci 2007;19:191–193.CrossRefGoogle ScholarPubMed
5.Weintraub, D, Lippmann, SB.Electroconvulsive therapy in the acute post-stroke period. J ECT 2000;16:415–418.CrossRefGoogle Scholar
6.Anwar, N, Brakoulias, V.Safety of electroconvulsive therapy after subdural haemorrhage. Aust N Z J Psychiatry 2010;44:294.CrossRefGoogle ScholarPubMed
7.Malek-Ahmadi, P, Hanretta, AT.Successful ECT in a patient with intracranial venous angioma. J ECT 2002;18: 99–102.CrossRefGoogle Scholar
8.Murray, GB, Shea, V, Conn, DK.Electroconvulsive therapy for poststroke depression. J Clin Psychiatry 1986;47: 258–260.Google ScholarPubMed
9.Currier, MB, Murray, GB, Welch, CC.Electroconvulsive therapy for post-stroke depressed geriatric patients. J Neuropsychiatry Clin Neurosci 1992;4:140–144.Google ScholarPubMed
10.Rasmussen, KG, Stevens, SR, Kung, S, Mohan, A.Melancholic symptoms as assessed by the Hamilton depression rating scale and outcomes with and without electroconvulsive therapy on an in-patient mood disorders unit. Acta Neuropsychiatrica 2010;22:21–25.CrossRefGoogle Scholar
11.American Psychiatric Association. Committee on Electroconvulsive therapy. The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging, 2nd edn. Washington DC: American Psychiatric Association, 2001.Google Scholar
12.Walter, G, Robertson, M, Rey, JM, Soh, N, Malhi, GS.Electroconvulsive therapy in young people and the pioneering spirit of Lauretta Bender. Acta Neuropsychiatrica 2010;22:253–254.CrossRefGoogle Scholar