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Updated: Sep 29, 2025

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Visual hallucinations following electroconvulsive therapy for major depressive disorder
Hayden P Nix1, Rookaya Mather2, Richard O'Reilly3
1Medicine, Western University, London, Ontario, Canada hnix@uwo.ca.
Electroconvulsive therapy (ECT) can cause temporary visual hallucinations in elderly patients with severe depression. These hallucinations resolved after ECT treatment cessation.
Area of Science:
- Neuroscience
- Geriatric Psychiatry
Background:
- Major depressive disorder in geriatric patients often requires intensive treatment.
- Electroconvulsive therapy (ECT) is an effective treatment for severe depression.
Observation:
- A female geriatric patient receiving right unilateral ECT for severe depression developed transient visual hallucinations.
- Hallucinations were brief, geometric, and increased in frequency with successive ECT treatments.
Findings:
- A strong temporal association was observed between ECT administration and the onset and resolution of visual hallucinations.
- Neuroimaging and ophthalmological exams ruled out organic causes for the visual disturbances.
Implications:
- Clinicians should consider visual hallucinations as a potential side effect of ECT in elderly patients.
- Awareness of this adverse effect is crucial for managing geriatric patients undergoing ECT.
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