Electroconvulsive therapy in a patient after radiation treatment of a brain metastasis: a case report.
Major depression has a high incidence in patients with cancer, but treatment guidelines for this vulnerable population are missing and antidepressants seem to be less effective than in patients not affected by cancer. We report the case of a patient with bronchial cancer with a single temporo-occipital brain metastasis that had been treated by radiotherapy (whole-brain radiation, 40 Gy, followed by a stereotactic radiotherapy, 15 Gy). The patient developed a major depressive episode and was successfully treated with electroconvulsive therapy without relevant adverse events. This case further underscores the safety and effectiveness of electroconvulsive therapy after radiotherapy of the brain and demonstrates a viable alternative for severely depressed patients with cancer who do not adequately respond to psychotherapy or pharmacotherapy alone.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. laura.kranaster@zi-mannheim.de
Laura
L
Kranaster
Carolin
C
Hoyer
Mathias
M
Krisam
Michael
M
Deuschle
Christoph
C
Janke
Alexander
A
Sartorius
D000928:Antidepressive Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D003865:Major Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011878:Radiotherapy / Q000009:adverse effects*
D000928:Antidepressive Agents