Electroconvulsive Therapy-Induced Mania in Bipolar Disorder: A Case Report

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Electroconvulsive therapy (ECT) is a primary treatment for severe bipolar disorder depression.
• ECT-induced mania, a switch to manic episodes during depression treatment, is recognized but poorly understood.
• Limited research exists on managing ECT-induced mania, complicating treatment guidelines.

Observation:

• A case study details a 56-year-old man with bipolar I disorder experiencing ECT-induced mania with psychosis during depression treatment.
• The manic switch coincided with valproate discontinuation, potentially increasing risk.
• Management involved temporarily suspending ECT, initiating lithium, and later resuming ECT with lithium maintenance.

Findings:

• The case demonstrates the potential for ECT to induce mania, especially with mood stabilizer withdrawal.
• A combination of ECT adjustment and mood stabilization (lithium) proved effective in this patient.
• Existing literature offers several strategies but lacks definitive guidelines due to limited evidence.

Implications:

• This case highlights the need for vigilant patient assessment and monitoring during ECT for bipolar disorder.
• Further research is crucial to establish optimal management and preventive strategies for ECT-induced mania.
• Understanding and addressing ECT-induced mania is vital for safe and effective bipolar disorder treatment.