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The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features.
| Content Provider | Europe PMC |
|---|---|
| Author | Perugi, Giulio Medda, Pierpaolo Toni, Cristina Mariani, Michela Giorgi Socci, Chiara Mauri, Mauro |
| Copyright Year | 2017 |
| Abstract | Objective:We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features.Method:522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features.Results:Of the original sample only 22 patients were excluded for the occurrence of side effects or consent withdrawal. After the ECT course, 344 (68.8%) patients were considered responders (final CGIi score ≤2) and 156 (31.2%) nonresponders. Response rates were respectively 68.1% for BD depression, 72.9% for mixed state, 75% for mania and 80.8% for catatonic features. Length of current episode and global severity of the illness were the only statistically significant predictors of nonresponse.Conclusion:ECT resulted to be an effective and safe treatment for all the phases of severe and drug-resistant BD. Positive response was observed in approximately two-thirds of the cases and in 80% of the catatonic patients. The duration of the current episode was the major predictor of nonresponse. The risk of ECT-induced mania is virtually absent and mood destabilization very unlikely. Our results clearly indicate that current algorithms for the treatment of depressive, mixed, manic and catatonic states should be modified and, at least for the most severe patients, ECT should not be considered as a “last resort”. |
| ISSN | 1570159X |
| Journal | Current Neuropharmacology |
| Volume Number | 15 |
| PubMed Central reference number | PMC5405614 |
| Issue Number | 3 |
| PubMed reference number | 28503107 |
| e-ISSN | 18756190 |
| DOI | 10.2174/1570159X14666161017233642 |
| Language | English |
| Publisher | Bentham Science Publishers |
| Publisher Date | 2017-04-01 |
| Access Restriction | Open |
| Rights License | This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. © 2017 Bentham Science Publishers |
| Subject Keyword | Bipolar depression Bipolar Disorder catatonia Electroconvulsive Therapy (ECT) Mania Mixed State Mood stabilizer |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Neurology (clinical) Pharmacology Pharmacology (medical) Psychiatry and Mental Health |
