title: Electroconvulsive therapy for severe neuropsychiatric lupus with psychosis.
abstract: OBJECTIVE
  Systemic lupus erythematosus (SLE) is an autoimmune disorder that requires long-term management and can have a profound impact on the quality of life of patients. Among patients with SLE, neuropsychiatric manifestations are fairly common, occurring in up to 75% of patients with SLE. Neuropsychiatric symptoms of SLE (NPSLE) presenting with psychosis, however, is less common, with a prevalence of up to 11%. Treatment of psychosis in NPSLE has largely involved antipsychotics and immunosuppressants, with not much in the literature about the use of electroconvulsive therapy (ECT) as a method of treatment.
  
  
  METHODS
  We report 3 cases of patients who presented with psychosis during a lupus relapse, who were treated successfully with ECT after their symptoms did not improve on medical treatment.
  
  
  CONCLUSIONS
  Although all 3 patients were treated with antipsychotics and immunosuppressants simultaneously with the ECT sessions, the time scale of these 3 case studies suggests that ECT played a role in the resolution of these patients' symptoms. Our 3 cases highlight that ECT can be safely and effectively used in patients with NPSLE with prominent psychotic symptoms.
authors.affiliation: Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore. Lynnette_Tan@ttsh.com.sg
authors.forename: Lynnette Pei Lin
authors.initials: LP
authors.lastname: Tan
authors.forename: Lynnette Ee Sing
authors.initials: LE
authors.lastname: Tan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000758:Anesthesia; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D044466:Asian People; D003520:Cyclophosphamide / Q000627:therapeutic use; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D014150:Antipsychotic Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide