ECT resistance and early relapse: two cases of subsequent response to venlafaxine.
Many depressed patients who fail to respond to numerous trials of antidepressant medications are ultimately referred for electroconvulsive therapy (ECT). However, a complete response does not occur in all depressed patients referred for ECT. The erroneous portrayal of ECT as a 'last ditch' treatment of depression leads to predictable despair if ECT fails or if early relapse occurs after a brief response. Therapeutic nihilism is not warranted in these cases. There is evidence in the literature that patients who fail to respond to adequate trials of antidepressant medications prior to ECT failure or early relapse subsequently respond to psychopharmacological treatment with high doses of venlafaxine. The following two case reports provide examples of depressed patients who subsequently responded to high doses of venlafaxine after demonstrating resistance to ECT, or experiencing rapid relapse after successful ECT.
Iodice
Aline J
AJ
Department of Psychiatry and Behavioral Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157-1087, USA. aiodice@wfubmc.edu
McCall
W Vaughn
WV
D018687:Antidepressive Agents, Second-Generation / Q000494:pharmacology* / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000494:pharmacology* / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010347:Patient Care Planning; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride