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Pernille Rønn Hoeck¹, Lars Vedel Kessing^2,3, Anne Katrine Pagsberg⁴

¹Region Hovedstadens Psykiatri, Børne- og Ungdomspsykiatrisk Center, Bispebjerg.

Ugeskrift for Laeger

|September 5, 2024

Summary

Electroconvulsive therapy (ECT) combined with reduced antipsychotic doses effectively treated a teen with severe bipolar mania. This approach resolved symptoms when standard medications failed, offering a viable alternative for complex cases.

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Area of Science:

Psychiatry
Neuroscience
Clinical Psychology

Background:

Bipolar affective disorder (BAD) is a serious mental health condition characterized by mood swings.
Mixed episodes, presenting with simultaneous manic and depressive symptoms, pose significant treatment challenges.
Standard pharmacological interventions, including lithium and antipsychotics, are first-line treatments but can have limited efficacy and side effects.

Observation:

A 15-year-old female presented with a mixed episode of BAD, predominantly featuring manic symptoms.
Initial treatment with lithium and multiple antipsychotic medications proved ineffective.
The patient experienced uncommon and undesirable side effects from the initial pharmacotherapy.

Findings:

Electroconvulsive therapy (ECT) was introduced in conjunction with dose reduction and discontinuation of antipsychotic medications.

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This combined treatment strategy led to measurable positive clinical effects.

The patient demonstrated significant improvement following the initiation of ECT.

Implications:

ECT can be a safe and effective treatment option for adolescent patients with treatment-resistant bipolar mania.
Combining ECT with optimized antipsychotic regimens may offer a superior therapeutic approach.
Further research into the role of ECT in pediatric and adolescent bipolar disorder is warranted.