title: Electroconvulsive Therapy Intervention for Parkinson's Disease.
abstract: BACKGROUND
  Electroconvulsive therapy is an established means to improve function in a variety of psychiatric and neurologic conditions, particularly for patients who remain treatment-refractory. Parkinson's disease is a neurodegenerative disorder that sometimes does not respond well to conventional pharmacotherapies. Reports have indicated that electroconvulsive therapy may be an effective and safe treatment for those patients with Parkinson's disease who are not optimally responding to first-line treatments. Despite these reports, however, electroconvulsive therapy is not often used by clinicians in patients with treatment-resistant Parkinson's disease, perhaps due to stigma, lack of knowledge regarding its safety and efficacy, and/or inability to predict the duration of therapeutic benefit.
  
  
  OBJECTIVE
  Our objective was to determine if the available literature on ECT supports it as a safe and effective treatment option in patients with treatment-refractory Parkinson's disease.
  
  
  CONCLUSIONS
  Motoric improvement induced by electroconvulsive therapy has been documented for decades in persons with Parkinson's disease. Efficacy and safety are reported following electroconvulsive therapy in people with Parkinson's disease who have sub-optimal response to medicines or experience the "on/off" phenomenon to L-dopa. Electroconvulsive therapy is an effective option for acute and maintenance treatment of Parkinson's disease in select patients. Inability to predict how long the beneficial effects of ECT therapy will last in patients with Parkinson's disease may be a reason why this treatment is underutilized by clinicians. More research is warranted to clarify parameters for application and duration of therapeutic benefit in individuals with difficult-to-treat Parkinson's disease.
authors.affiliation: Dr. Narang is Assistant Professor with the University of Minnesota and Staff Physician and Lead ECT Psychiatrist at Regions Hospital, Minneapolis-St. Paul, Minnesota; Dr. Glowacki is a first year family medicine resident at John Peter Smith hospital, Fort Worth Texas; and Dr. Lippmann is Professor of Psychiatry at University of Louisville School of Medicine, Louisville, Kentucky.
authors.forename: Puneet
authors.initials: P
authors.lastname: Narang
authors.affiliation: Dr. Narang is Assistant Professor with the University of Minnesota and Staff Physician and Lead ECT Psychiatrist at Regions Hospital, Minneapolis-St. Paul, Minnesota; Dr. Glowacki is a first year family medicine resident at John Peter Smith hospital, Fort Worth Texas; and Dr. Lippmann is Professor of Psychiatry at University of Louisville School of Medicine, Louisville, Kentucky.
authors.forename: Anna
authors.initials: A
authors.lastname: Glowacki
authors.affiliation: Dr. Narang is Assistant Professor with the University of Minnesota and Staff Physician and Lead ECT Psychiatrist at Regions Hospital, Minneapolis-St. Paul, Minnesota; Dr. Glowacki is a first year family medicine resident at John Peter Smith hospital, Fort Worth Texas; and Dr. Lippmann is Professor of Psychiatry at University of Louisville School of Medicine, Louisville, Kentucky.
authors.forename: Steven
authors.initials: S
authors.lastname: Lippmann
keywords: ECT; Electroconvulsive therapy; Parkinson’s disease; motor symptoms; “on-off” phenomenon