title: Electroconvulsive therapy in the treatment of depression in a former ecstasy user.
abstract: Depression in former ecstasy users may not respond to selective serotonin reuptake inhibitors (SSRIs) possibly due to damaged serotonergic synapses following long-term heavy ecstasy use. We report findings in a patient suffering from MDMA-induced depression which was refractory to several antidepressive medications including selective noradrenergic reuptake inhibitor (SNRI) and SSRI. An add-on repeated bilateral electroconvulsive therapy (ECT) was able to achieve a stable remission of affective and cognitive symptoms with a follow-up of more than 1.5 years. Add-on ECT could be a treatment option in former ecstasy users with severe depressive disorders that fail to respond to SSRI and/or SNRI. Clinical trials are needed to evaluate further the usefulness of ECT in this patient group.
authors.affiliation: Department of Psychiatry, University of Ulm, Ulm, Germany. roland.freudenmann@uni-ulm.de
authors.forename: Roland W
authors.initials: RW
authors.lastname: Freudenmann
authors.forename: Carlos
authors.initials: C
authors.lastname: Schönfeldt-Lecuona
authors.forename: Manfred
authors.initials: M
authors.lastname: Spitzer
authors.forename: Leopold
authors.initials: L
authors.lastname: Hermle
authors.forename: Georg
authors.initials: G
authors.lastname: Grön
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000328:Adult; D003865:Major Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy; D006213:Hallucinogens; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D017367:Selective Serotonin Reuptake Inhibitors