The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State

Giulio Perugi; Pierpaolo Medda; Margherita Barbuti; Martina Novi; Beniamino Tripodi

doi:10.1016/j.psc.2019.10.010

The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State

Psychiatr Clin North Am. 2020 Mar;43(1):187-197. doi: 10.1016/j.psc.2019.10.010. Epub 2019 Dec 2.

Authors

Giulio Perugi¹, Pierpaolo Medda², Margherita Barbuti², Martina Novi², Beniamino Tripodi²

Affiliations

¹ Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy; Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. Electronic address: giulio.perugi@med.unipi.it.
² Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy.

PMID: 32008684
DOI: 10.1016/j.psc.2019.10.010

Abstract

Electroconvulsive therapy (ECT) results effective in two-thirds of the patients with severe and drug-resistant mixed states. The episode duration is the main predictor of nonresponse. This practice may increase the risk of mood destabilization and chronic complications and may decrease the chance of recovery in many patients. Compared with the burden of neurologic and metabolic side effects associated with long-term use of complex pharmacologic regimens, ECT should be considered a safe option with a very low incidence of severe adverse events and a long-term nondestabilizing effect.

Keywords: Bipolar disorder; Electroconvulsive therapy; Mixed states.

Publication types

Review

MeSH terms

Bipolar Disorder / therapy*
Depressive Disorder, Major / therapy*
Electroconvulsive Therapy*
Humans
Treatment Outcome