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CPK Measurements and ECT in Polymyositis: A Case Report
Benjamin Delucia1, Rachit Patel, Adeeb Yacoub
1DELUCIA, and YACOUB: Department of Psychiatry and Behavioral Science, School of Medicine, State University of New York at Stony Brook, Stony Brook, NY PATEL: Department of Psychiatry, Stamford Hospital, Stamford, CT FRANCIS: Department of Psychiatry, Penn State School of Medicine, Hershey PA.
Electroconvulsive therapy (ECT) can be a safe and effective treatment for depression in patients with inflammatory myopathies, such as polymyositis (PM). Careful monitoring of creatine phosphokinase (CPK) levels is recommended during maintenance therapy.
Area of Science:
- Neurology
- Psychiatry
Background:
- Inflammatory myopathies, like polymyositis (PM), may pose risks during electroconvulsive therapy (ECT) due to potential muscle sensitivity.
- Elevated creatine phosphokinase (CPK) levels, an indicator of muscle damage, have been observed in some patients undergoing ECT.
Observation:
- A 74-year-old female with biopsy-proven PM developed depression following steroid treatment.
- She received 21 ECT sessions over two years for treatment-resistant depression.
- Each ECT course effectively managed her depression without exacerbating myopathy symptoms.
Findings:
- This case is the first to describe maintenance phase ECT in a patient with inflammatory myopathy.
- Creatine phosphokinase (CPK) levels were monitored throughout the treatment period.
- ECT proved effective for depression and did not worsen the patient's underlying muscle disease.
Implications:
- Electroconvulsive therapy (ECT) can be a viable treatment option for depression in patients with inflammatory myopathies.
- Maintenance ECT may be safely administered with appropriate creatine phosphokinase (CPK) monitoring.
- Further research is warranted to establish definitive guidelines for ECT use in this patient population.
