title: Refractory major depression successfully treated with electroconvulsive therapy in a patient with Addison disease.
abstract: This report describes a 55-year-old woman who had 1 previous episode of major depression that responded favorably to treatment with tricyclic antidepressants. After the development of Addison disease, she experienced a new episode of major depression that failed to respond to adequate treatment with imipramine and was subsequently successfully treated with electroconvulsive therapy (ECT) with steroid cover. The patient did not experience adrenal crisis or adverse effects. After 9 ECT sessions, she attained full remission. These findings support the suggestion that ECT treatment is safe in patients with Addison disease when using 100 mg intravenous hydrocortisone as prophylaxis.
authors: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Willemijn T C J
authors: WT
authors: Heijnen
authors: Esther M
authors: EM
authors: Pluijms
authors: Tom K
authors: TK
authors: Birkenhager
mesh_terms: D000224:Addison Disease / Q000150:complications*; D000758:Anesthesia; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone