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Maintenance electroconvulsive therapy and cognitive function

R C Barnes1, A Hussein, D N Anderson

  • 1Whiston Hospital, Prescot, Merseyside.

The British Journal of Psychiatry : the Journal of Mental Science
|March 1, 1997
PubMed
Summary
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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.

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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.