title: Treatment of mania in dementia with electroconvulsive therapy.
abstract: Symptoms of mania have been given inadequate attention as a source of agitated behavior in the dementia patient. Characterized by elevation in mood or grandiosity, pressured speech, and impulsivity, mania is common among the elderly population, with a prevalence approaching 20% in some studies. Because it is so highly associated with behavioral agitation, mania has a significant impact on patient management, and can often lead to the institutionalization of difficult patients. Here we present a case series of three elderly individuals who had signs of mania in conjunction with dementia. Refractory to psychotropic medications, all were given an acute plus maintenance courses of right-unilateral electroconvulsive therapy (ECT). The patients achieved significant improvement in signs of mania and agitation, as well as in mental status scores. We conclude that a short course of ECT, followed by maintenance treatments every 2 weeks, can contribute significantly to the management of dementia patients whose behavioral agitation is associated with signs of mania.
authors.affiliation: Fuqua Center for Late-Life Depression, Wesley Woods Geriatric Center, 1841 Clifton Road, Atlanta, Georgia 30329, USA. williamcdonald@emory.edu
authors.forename: W M
authors.initials: WM
authors.lastname: McDonald
authors.forename: T R
authors.initials: TR
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000628:therapy; D008297:Male; D011595:Psychomotor Agitation / Q000628:therapy