[Electroconvulsive therapy in a patient with Huntington's disease and depression: a case-report]

We present the case of a 60-year-old woman with Huntington’s disease who was successfully treated with electroconvulsive therapy (ECT) for a recurrent depressive disorder presenting with acute suicidality. Depression is the most common neuropsychiatric disorder in Huntington’s disease and ranks among the most important risk factors for suicide within this population. Depressive symptoms in individuals with Huntington’s disease are generally treated in accordance with established guidelines for major depressive disorder in the general population. However, the etiology and pathophysiology of depression in Huntington’s disease are, in part, distinct. In clinical practice, pharmacological treatment typically consists of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these are not always sufficiently effective, and in urgent situations such as acute suicidality, a more rapid therapeutic approach may be required. ECT appears to be an effective treatment modality in such cases, similarly to its use in patients without Huntington’s disease. Given the limited literature currently available, the possible effects of ECT on motor symptoms and cognitive functioning in patients with Huntington’s disease warrant further investigation.