[Electroconvulsive therapy in the treatment of severe mania. Case report and a state-of-art review].
Despite newly developed pharmacological possibilities, treatment of acute mania may still be a problem in single patients. Independent of the first choice of medication, i.e. neuroleptics, lithium, carbamazepine or valproate, the average response rate is only approximately 50-70%. Therefore, treating mania often implies a number of monotherapeutic and polypharmaceutic attempts for several months, until a sufficient mood stabilization has been reached. The aim of this case report is to remind that electroconvulsive therapy (ECT) is still in use for treating mania, which has been widely neglected in Germany despite its high success rate, mainly reported from Anglo-Saxon countries. As demonstrated in this report, ECT may be a useful tool for a fast antimanic response in patients which may be either refractory to standard treatment or are medically severely ill, and should, in our opinion, therefore be considered already at an earlier stage of treatment in this group. However, persistence of improvement can usually only be achieved with the overlapping start of drug treatment unless the option of maintenance ECT is given.
Grunze
H
H
Psychiatrische Klinik, Ludwig-Maximilians-Universität, München.
Erfurth
A
A
Schäfer
M
M
Amann
B
B
Meyendorf
R
R
D000208:Acute Disease; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000188:drug therapy*; D001714:Bipolar Disorder / Q000150:complications* / Q000628:therapy*; D003072:Cognition Disorders / Q000209:etiology; D018432:Drug Resistance, Multiple; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D018692:Antimanic Agents
Elektrokonvulsionstherapie in der Behandlung der schweren Manie. Kasuistik und Wissensstand.