title: ECT and lithium in old age depression - cause or treatment of rapid cycling?
abstract: OBJECTIVE
  This article presents the case of an elderly woman experiencing a depressive phase of Bipolar Affective Disorder 1 (BPAD1), who required electroconvulsive therapy (ECT), prior to which her lithium was ceased, and who developed ultra-ultra-rapid cycling (UURC) and ultra-rapid cycling (URC). This resolved with the recommencement of lithium and continuation of ECT.
  
  
  METHODS
  Case report and review of the relevant literature.
  
  
  RESULTS
  The patient's mood stabilized with recommencement of lithium and continuation of ECT.
  
  
  CONCLUSIONS
  Ceasing lithium prior to ECT may carry a risk of URC or UURC in BPAD1.
authors.affiliation: St Vincent's Hospital, Sydney, NSW, Australia Jacqueline.huber@svha.org.au.
authors.forename: Jacqueline P
authors.initials: JP
authors.lastname: Huber
authors.affiliation: Director, Psychogeriatric Service, St Vincent's Hospital, Sydney, NSW, and; Associate Professor, University of Notre Dame, Sydney, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Burke
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy*; D003131:Combined Modality Therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage*
chemical_list: D000928:Antidepressive Agents; D018020:Lithium Compounds
keywords: bipolar affective disorder; electroconvulsive therapy; lithium; old age; ultra-rapid cycling