title: Maintenance electroconvulsive therapy for recurrent refractory mania.
abstract: BACKGROUND
  Although there are some reports on the efficacy of maintenance electroconvulsive therapy (mECT) in rapid cycling bipolar disorder there is scant data about the use of mECT in the non-rapid cycling form of this condition.
  
  
  METHODS
  We report the case of a 45-year-old man diagnosed with bipolar affective disorder at the age of 32 who had 5 manic episodes in 6 years. These episodes were severe, required hospitalization and had poor response to lithium carbonate, sodium valproate, carbamazepine, haloperidol and chlorpromazine (either alone or in combination). The patient was treated with electroconvulsive therapy (ECT) during his last hospitalization and since then his treatment has included mECT and chlorpromazine (400 mg/day) and he has remained euthymic during the past 21 months.
  
  
  CONCLUSIONS
  This case describes the utility of mECT in medication refractory bipolar disorder.
authors.affiliation: Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil. antonioleandro@superig.com.br
authors.forename: Antonio Leandro
authors.initials: AL
authors.lastname: Nascimento
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Appolinario
authors.forename: Daniel
authors.initials: D
authors.lastname: Segenreich
authors.forename: Maria Tavares
authors.initials: MT
authors.lastname: Cavalcanti
authors.forename: Marco Antonio Alves
authors.initials: MA
authors.lastname: Brasil
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy / Q000379:methods*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012008:Recurrence
chemical_list: D014150:Antipsychotic Agents; D016651:Lithium Carbonate