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Published on: January 7, 2019
Use of Electroconvulsive Therapy in Adolescents With Treatment-Resistant Depressive Disorders: A Case Series
Naista Zhand1, Darren B Courtney, Martine F Flament
1From the *Department of Psychiatry, University of Ottawa, Ottawa; †Youth Concurrent Disorders Inpatient Unit, Centre for Addiction and Mental Health; ‡Department of Psychiatry, University of Toronto, Toronto; §Youth Unit at the University of Ottawa Institute of Mental Health Research; and ∥Department of Psychiatry and Psychology, University of Ottawa, Ottawa, Ontario, Canada.
Objectives:
This study presents a comprehensive case series of adolescents who received electroconvulsive therapy (ECT) for treatment-resistant depression.
Methods:
Conducting a chart review, we identified 13 adolescents who had ECT for treatment of depression over a 5-year interval (2008-2013) at a Canadian tertiary care psychiatric hospital. Details about participants' clinical profile, index course of ECT, outcome, side effects, and comorbidities were extracted and analyzed.
Results:
Thirteen adolescents aged 15 to 18 years, received a mean of 14 (SD, 4.5) ECT sessions per patient. Based on the Beck Depression Inventory-II at baseline and after treatment with ECT, a reliable improvement was observed in 10 patients, with 3 achieving full recovery. Through mixed effects linear modeling, we found a decrease of 0.96 points (95% CI, -1.31 to -0.67, P < 0.001) on the Beck Depression Inventory-II total score for every ECT treatment received. The Montreal Cognitive Assessment was used for monitoring of cognitive function throughout the treatment. Adverse effects included transient subjective cognitive impairment (n = 11), headache (n = 10), muscular pain (n = 9), prolonged seizure (n = 3), and nausea and/or vomiting (n = 3).
Conclusions:
A clinically significant improvement was observed for 10 (77%) adolescents receiving ECT for treatment-resistant depression. These observations suggest that ECT is a potential treatment option for refractory depression in selected adolescents. More data are needed to draw conclusions about efficacy and possible predictors of treatment response.
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