Recurrence After Stopping Maintenance Electroconvulsive Therapy: A Retrospective Case Series

Area of Science:

• Psychiatry
• Neurology
• Clinical Psychology

Background:

• Relapse and recurrence are significant risks for patients with severe mood disorders post-electroconvulsive therapy (ECT).
• Limited data exists on depression recurrence rates specifically after maintenance ECT (mECT) discontinuation.

Purpose of the Study:

• To investigate the recurrence rate of mood disorders after discontinuing maintenance ECT.
• To compare literature findings with a retrospective case study analysis.

Main Methods:

• Conducted a comprehensive literature review on ECT discontinuation and recurrence.
• Performed a retrospective analysis of 18 patients who discontinued mECT between 2011 and 2016.

Main Results:

• Only 3 prior studies assessed recurrence rates after ECT discontinuation.
• In the retrospective analysis, 50% of patients experienced a new mood event (typically depression) after mECT cessation.
• Recurrences predominantly occurred within the first six months post-discontinuation (44% of cases).

Conclusions:

• High recurrence rates necessitate discussion on the benefits of long-term mECT.
• Consideration of concomitant pharmacotherapy is crucial for managing severe and complex affective disorders post-mECT.