Maintenance electroconvulsive therapy for recurrent refractory mania

Area of Science:

• Neuroscience
• Psychiatry

Background:

• Limited data exists on maintenance electroconvulsive therapy (mECT) for non-rapid cycling bipolar disorder.
• Electroconvulsive therapy (ECT) is a recognized treatment for severe mood disorders.

Observation:

• A 45-year-old male with bipolar affective disorder experienced frequent, severe manic episodes.
• The patient demonstrated poor response to multiple pharmacological interventions, including lithium, valproate, and carbamazepine.

Findings:

• Following acute electroconvulsive therapy (ECT), the patient received maintenance electroconvulsive therapy (mECT) combined with chlorpromazine.
• The patient achieved and maintained euthymia for 21 months under this treatment regimen.

Implications:

• Maintenance electroconvulsive therapy (mECT) may be a valuable therapeutic option for medication-refractory bipolar disorder, even in non-rapid cycling presentations.
• This case underscores the potential of mECT in managing complex and treatment-resistant bipolar disorder cases.