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Maintenance electroconvulsive therapy and cognitive function
R C Barnes1, A Hussein, D N Anderson
1Whiston Hospital, Prescot, Merseyside.
Summary
Maintenance electroconvulsive therapy (ECT) appears safe for bipolar disorder, with cognitive effects similar to acute ECT and not worsening over time. This suggests ECT can be a viable long-term prophylactic treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Electroconvulsive therapy (ECT) is infrequently employed as a prophylactic treatment.
- A unique case involving a 74-year-old woman with unstable bipolar disorder undergoing maintenance ECT provided an opportunity to assess cognitive impacts.
Observation:
- The patient received over 400 maintenance ECT treatments as a sole form of ongoing therapy.
- Serial psychometric testing was administered throughout the course of treatment.
Findings:
- No progressive cognitive decline was observed during maintenance ECT.
- Cognitive deficits consistent with acute ECT were present but did not worsen.
- Treatment frequency may influence the severity of cognitive difficulties.
Implications:
- Maintenance ECT can serve as an effective prophylactic strategy for carefully selected patients.
- Cognitive side effects of maintenance ECT appear comparable to acute treatment and are non-progressive.
- This case supports the long-term use of ECT for managing chronic mood disorders.