ECT-induced interictal delirium in patients with a history of a CVA.
Earlier works have documented a high incidence of affective disorders in patients with a history of a cerebrovascular accident (CVA). In general, electroconvulsive therapy (ECT) has been reported to be effective in treating depressed patients with a history of CVA. Recent works have shown that preexisting structural brain changes may predispose patients to develop interictal ECT-induced delirium. However, the incidence of ECT-induced interictal delirium in patients with a history of CVA has not been directly studied. In this pilot study, the authors examined the incidence of ECT-induced interictal delirium in 14 depressed CVA patients compared with 14 elderly depressed controls (without a history of CVA). Interestingly, the overall incidence of delirium was identical in both groups (28.5%). However, consistent with previous works, some patients who had had a recent CVA involving the caudate nucleus appeared more likely to develop delirium. Thirteen of the 14 depressed CVA patients (92%) showed a moderate to significant improvement in their depressive symptoms from ECT. None of the patients developed significant cardiac complications during ECT.
Martin
M
M
Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110.
Figiel
G
G
Mattingly
G
G
Zorumski
C F
CF
Jarvis
M R
MR
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D002561:Cerebrovascular Disorders / Q000503:physiopathology*; D003693:Delirium / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors