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ECT in the Treatment of Organic Psychosis in Huntington's Disease

Dwight L. Evans1, Cort A. Pedersen, Manuel E. Tancer

  • 1Department of Psychiatry, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA.

Convulsive Therapy
|January 1, 1987
PubMed

Insights

Electroconvulsive therapy (ECT) effectively treated psychosis and depression in a Huntington

Area of Science:

  • Neuroscience
  • Psychiatry
  • Neurology

Background:

  • Huntington's disease (HD) is a progressive neurodegenerative disorder.
  • Psychiatric symptoms, including psychosis, are common in HD and can necessitate long-term hospitalization.
  • Psychosis in HD is often refractory to standard neuroleptic treatments.

Purpose of the Study:

  • To report a case of refractory organic psychotic syndrome in a patient with Huntington's disease.
  • To evaluate the efficacy of electroconvulsive therapy (ECT) in treating psychosis and depressive symptoms in HD.
  • To explore the potential of ECT to prevent or delay long-term psychiatric hospitalization in HD patients with psychosis.

Main Methods:

  • A case report of a 49-year-old female patient with a 1-year history of Huntington's disease.
  • The patient presented with organic psychotic syndrome, including suicidal and homicidal ideation, refractory to high-dose neuroleptics and antidepressants.
  • Electroconvulsive therapy (ECT) was administered due to persistent psychosis and risk of long-term psychiatric placement.

Main Results:

  • Electroconvulsive therapy (ECT) successfully resolved the psychotic symptoms, including suicidal and homicidal ideation.
  • ECT also effectively treated emergent depressive symptoms without worsening dementia or significantly accelerating choreiform movements.
  • The patient avoided long-term psychiatric hospitalization.

Conclusions:

  • Electroconvulsive therapy (ECT) may be a beneficial treatment for psychosis in Huntington's disease, with or without depressive symptoms.
  • Further research is warranted to establish the role of ECT in managing psychosis in HD and preventing psychiatric institutionalization.
  • ECT offers a potential therapeutic option for refractory psychiatric manifestations of Huntington's disease.

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