A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience
Issue link: https://innovationscns.epubxp.com/i/555782
Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 2 , N U M B E R 7 – 8 , J U L Y – A U G U S T 2 0 1 5 ] 30 regarding neurologic deterioration following ECT are not clear. 14–16 There is no pattern in ECT's potential for deleterious effects. In t he reviewed literature, patients that displayed loss of neurologic function induced by ECT were of different ages, had varied levels of neurodegeneration, and dissimilar neuropsychiatric presentations. There was no correlation between symptom severity and laterality of ECT electrode placement. Thus, decisions to select ECT for treating co-existing psychiatric disorders and MS must be made on an individualized basis that involves risk-versus-benefit discussions with patients. In addition to MS, other neurodegenerative disorders are also associated with depression and increased suicide rate. 3 –5 The literature analyzing ECT outcomes or sequellae in these patients is sparse and without clear findings or recommendations. Clearly, further research into use of ECT for treatment of psychiatric illness in patients with MS and other neurodegenerative disorders is needed before firm conclusions can be drawn regarding its safety. REFERENCES 1. American Psychiatric Association. The Practice of ECT: Recommendations for Treatment, Training, and Privileging. Washington, DC: American Psychiatric Press, Inc.; 2001. 2. Fink M, Taylor MA. Electroconvulsive therapy: evidence and challenges. J Am Med Assoc. 2007;298(3):330–332. 3. Chwastiak L, Ehde DM, Gibbons LE, et al. Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample. Am J Psychiatry. 2002;159:1862–1868. 4. Carta MG, Moro MF, Lorefice L, et al. The risk of bipolar disorder in multiple sclerosis. J Affect Disord. 2014;155:255–260. 5. Pompili M, Forte A, Palermo M, et al. Suicide risk in multiple sclerosis: a systematic review of current literature. J Psychosomat Res. 2012;73(6):411–417. 6. Kirzinger SS, Jones J, Siegwald A, et al. Relationship between disease-modifying therapy and depression in multiple sclerosis. Int J MS Care. 2013;15(3):107–12. 7. Rabins PV, Brooks BR, O'Donell P, et al. Structural brain correlates of emotional disorder in multiple sclerosis. Brain. 1986;109:585–597. 8. Bieske AG, Svensson E. Depression and anxiety amongst multiple sclerosis patients. Eur J Neurol. 2008;15:239–245. 9. Sadovnic AD, Remick RA. Depression and multiple sclerosis. Neurology. 1996;46(3):628–632. 10. Amato MP, Ponziani G, Rossi F, et al. Quality of life in patient's with multiple sclerosis: the impact of depression, fatigue, and disability. Multiple Sclerosis Journal. 2001;7(5):340–344. 11. Arnett PA, Randolph JJ. Longitudinal course of depression symptoms in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2006;77:606–610. 12. Minden SL, Feinstein A, Kalb RC, et al. Evidence-based guideline: assessment and management of psychiatric disorders in individuals with MS: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014;82(2):174–181. 13. Mattingly G, Baker K, Zorumski CF, et al. Multiple sclerosis and ECT: possible value of gadolinium- enhanced magnetic resonance scans for identifying high risk patients. J Neuropsychiatry Clin Neurosci. 1992;4:145–151. 14. Rasmussen KG, Keegan BM. Electroconvulsive therapy in patients with multiple sclerosis. J ECT. 2007;23(3):179–180. 15. Pontikes TK, Dinwiddie SH. Electroconvulsive therapy in a patient with multiple sclerosis and recurrent catatonia. J ECT. 2010;26(4):270–271. 16. Urban-Kowalczyk M, Rudecki T, Wroblewski D, et al. Electroconvulsive therapy in patient with psychotic depression and multiple sclerosis. Neurocase. 2014;20(4):452–455.