Maintenance electroconvulsive therapy: Are we clutching at straws?

Area of Science:

• Psychiatry
• Neurology
• Clinical Psychology

Background:

• Limited treatment options exist for drug or treatment-resistant psychiatric disorders.
• Maintenance electroconvulsive therapy (M-ECT) is an established treatment, yet literature on its utilization is scarce.
• Understanding M-ECT's role in tertiary care is crucial for managing complex psychiatric conditions.

Purpose of the Study:

• To examine the utilization patterns of M-ECT in a large tertiary care psychiatric facility.
• To identify the socio-demographic and clinical characteristics of patients receiving M-ECT.
• To assess the effectiveness of M-ECT in treatment-resistant psychiatric disorders.

Main Methods:

• Retrospective chart review conducted at a tertiary care psychiatry center in semi-urban South India.
• Analysis of data from patients who received electroconvulsive therapy (ECT) during the study period.
• Focus on patients undergoing maintenance electroconvulsive therapy (M-ECT).

Main Results:

• Only five out of 171 ECT patients received M-ECT.
• M-ECT patients were diagnosed with treatment-resistant conditions, primarily schizophrenia.
• These patients lived within 30 km of the hospital, required high caregiver support, and had residual symptoms despite regular treatment.

Conclusions:

• M-ECT demonstrates effectiveness for severe psychiatric disorders, especially treatment-resistant schizophrenia.
• The study highlights the profile of patients who benefit from M-ECT.
• Psycho-social factors influencing adherence to M-ECT warrant further consideration.