Electroconvulsive therapy (ECT) in bipolar disorder: A narrative review of literature

Asian Journal of Psychiatry
Jagadisha ThirthalliBangalore N Gangadhar

Abstract

In many countries including India electroconvulsive therapy (ECT) is frequently used to treat different phases of bipolar disorder. The response to ECT is impressive in mania, depression and in mixed affective states. Preliminary evidence also suggests benefit from maintenance ECT in bipolar disorder. However, most of the literature on efficacy and adverse effects comes from case series, retrospective reports and open trials - controlled trials have been few and far between. Official guidelines recommend the use of ECT only when there is a dire emergency or when all other options have been exhausted. Concurrent use of lithium and antiepileptic drugs along with ECT is common in clinical practice. While such practice appears to be largely safe, one should be mindful about dose of lithium and possible interference of antiepileptic drugs with efficacy of ECT. The use of suprathreshold bilateral ECT and bifrontal placement of electrodes may confer some advantage over other methods.

Citations

Apr 14, 2018·Indian Journal of Dental Research : Official Publication of Indian Society for Dental Research·Satheesh B HaralurAmer Abdullah Al-Shehri
May 6, 2019·International Journal of Bipolar Disorders·Christopher C AbbottMauricio Tohen
Feb 8, 2019·The Australian and New Zealand Journal of Psychiatry·Yc Janardhan ReddySujay Kulkarni

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