Postpartum electroconvulsive therapy: a systematic review and case report.
OBJECTIVE
Postpartum depression can have devastating consequences on the mother and child. Prompt treatment is challenging. Whereas electroconvulsive therapy (ECT) is considered to be an effective treatment modality in severe depression and brings about rapid clinical improvement, little is known about ECT during the postpartum period.


METHODS
We systematically reviewed the literature on the use of ECT during the postpartum period using PubMed, Institute for Scientific Information Web of Knowledge and PsycINFO databases until September 2014, using the search terms "electroconvulsive therapy" or "ECT" and "postpartum". Then, we described the successful treatment with ECT and the joint mother-baby hospitalization of a woman with severe depression.


RESULTS
Eight case reports and 8 studies were identified. All of the studies reported that ECT is effective in the postpartum period. It is well tolerated, provides a fast response and allows for breastfeeding. In addition, our case report showed the benefits of the hospitalization of the mother-baby unit.


CONCLUSIONS
Combined ECT and joint mother-baby hospitalization could be a valuable treatment by targeting both the mother-infant relationship and the maternal depressive symptoms.
Inserm UMR 1178 Team "Depression and Antidepressants", Univ Paris Sud, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Le Kremlin Bicêtre, France. Electronic address: florence.gressier@bct.aphp.fr.
Florence
F
Gressier
Inserm UMR 1178 Team "Depression and Antidepressants", Univ Paris Sud, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
Samuel
S
Rotenberg
Department of Psychiatry, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
Odile
O
Cazas
Inserm UMR 1178 Team "Depression and Antidepressants", Univ Paris Sud, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
Patrick
P
Hardy
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019052:Depression, Postpartum / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D009034:Mother-Child Relations; D011247:Pregnancy; D012720:Severity of Illness Index
D000928:Antidepressive Agents
Electroconvulsive therapy; Mother–baby unit; Mother–infant relationship; Postpartum; Postpartum depression