Practice parameter for use of electroconvulsive therapy with adolescents.
Electroconvulsive therapy (ECT) may be an effective treatment for adolescents with severe mood disorders and other Axis I psychiatric disorders when more conservative treatments have been unsuccessful. ECT may be considered when there is a lack of response to two or more trials of pharmacotherapy or when the severity of symptoms precludes waiting for a response to pharmacological treatment. The literature on ECT in adolescents, including studies and case reports, was reviewed and then integrated into clinically relevant guidelines for practitioners. Mood disorders have a high rate of response to ECT (75%-100%), whereas psychotic disorders have a lower response rate (50%-60%). Consent of the adolescent's legal guardian is mandatory, and the patient's consent or assent should be obtained. State legal guidelines and institutional guidelines must be followed. ECT techniques associated with the fewest adverse effects and greatest efficacy should be used. The presence of comorbid psychiatric disorder is not a contraindication. Systematic pretreatment and posttreatment evaluation, including symptom and cognitive assessment, is recommended.
Ghaziuddin
Neera
N
Kutcher
Stanley P
SP
Knapp
Penelope
P
Bernet
William
W
Arnold
Valerie
V
Beitchman
Joseph
J
Benson
R Scott
RS
Bukstein
Oscar
O
Kinlan
Joan
J
McClellan
Jon
J
Rue
David
D
Shaw
Jon A
JA
Stock
Saundra
S
Kroeger Ptakowski
Kristin
K
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000266:history / Q000295:instrumentation; D000075202:Contraindications; D004565:Electroconvulsive Therapy / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D012017:Referral and Consultation