Chronic renal failure, hemodialysis, and electroconvulsive therapy: a case report

We present a case study of a 60-year-old man with history of chronic renal failure on hemodialysis with severe bipolar I depression. Referred for worsening psychotic depression associated with refusal of oral intake and severe hypokinesia unresponsive to several antidepressant regimens, he was treated successfully with a course of bilateral electroconvulsive therapy. The patient experienced a robust response to treatment, with a 34 to 6 reduction in Hamilton Depression Rating Scale score. The potential challenges associated with administering electroconvulsive therapy to this patient population are discussed.