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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
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: [email protected]

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.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

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