Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-23T21:27:14.746Z Has data issue: false hasContentIssue false
  • English
  • Français

Looking beyond electroconvulsive therapy: A case report

Published online by Cambridge University Press:  13 August 2021

D. Barbosa ,
A. Sousa ,
A.S. Machado ,
R. Moreira  and
M. Mota
D. Barbosa*
Affiliation:
Psychiatry, Sao Joao Hospital and University Centre, Porto, Portugal
A. Sousa
Affiliation:
Psychiatry, Sao Joao Hospital and University Centre, Porto, Portugal
A.S. Machado
Affiliation:
Psychiatry, Sao Joao Hospital and University Centre, Porto, Portugal
R. Moreira
Affiliation:
Psychiatry, Sao Joao Hospital and University Centre, Porto, Portugal
M. Mota
Affiliation:
Psychiatry, Sao Joao Hospital and University Centre, Porto, Portugal
*
*Corresponding author.

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction

Electroconvulsive therapy (ECT) is considered a gold-standart treatment of severe and treatment-resistant depression. Lack of response to ECT often causes distress in psychiatrists regarding the next therapeutic decisions.

Objectives

To present a case report of a patient with psychotic depression with partial response to ECT.

Methods

Clinical interviews and review of literature using the Pubmed platform.

Results

The authors present a case of a 60 year-old woman admitted for severe depressive episode with psychotic symptoms. Due to lack of response to multiple antidepressive and antipsychotic treatments, 15 sessions of ECT were performed with improvement of behavioral and psychotic symptoms. However, endogenous depressive symptoms with functional impairment persisted. It was then initiated Bupropion 300mg/day resulting in vast improvements on drive, energy and activity levels with restored functionality. Previously to ECT, Bupropion was not considered a valid option due to the psychomotor restlessness that was present. This case exposes the limitations of ECT and the therapeutic conundrums that arise when there is partial response. The symptoms expressed in the patient after ECT course correlate with deficits in noradrenergic and dopaminergic pathways that are involved in endogenous depression. The use of Bupropion, with its effect on noradrenaline and dopamine receptors, may offer a therapeutic lifeline in these cases.

Conclusions

ECT still stands as a gold-standart for severe depressive disorder, especially when several psychopharmacological therapies have failed. In cases of partial response to ECT, the neurobiological correlates of clinical presentation can guide the therapeutic management towards improved outcomes.

Disclosure

No significant relationships.

Keywords

Electroconvulsive therapyDepressiontreatment response
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S781 - S782
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
Submit a response

Comments

No Comments have been published for this article.