title: Electroconvulsive therapy for depression in Parkinson's disease: systematic review of evidence and recommendations.
abstract: OBJECTIVE
  We performed a systematic review of evidence regarding treatment of depression in Parkinson's disease (PD) utilizing electroconvulsive therapy.
  
  
  METHODS
  The search led to the inclusion of 43 articles, mainly case reports or case series, with the largest number of patients totaling 19.
  
  
  RESULTS
  The analysis included 116 patients with depression and PD; depression improved in 93.1%. Where motor symptoms' severity was reported, 83% of patients improved. Cognition did not worsen in the majority (94%). Many patients experienced delirium or transient confusion, sometimes necessitating discontinuation of electroconvulsive therapy (ECT). Little is known about maintenance ECT in this population.
  
  
  CONCLUSIONS
  ECT can benefit patients suffering from PD and depression. We recommend an algorithm for treatment of depression in PD, utilizing ECT sooner rather than later.
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA.|Veterans' Affairs Medical Center, Seattle, WA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Borisovskaya
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA.
authors.forename: William Culbertson
authors.initials: WC
authors.lastname: Bryson
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA.|Veterans' Affairs Medical Center, Seattle, WA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buchholz
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA.|Veterans' Affairs Medical Center, Seattle, WA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Samii
authors.affiliation: University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Soo
authors.initials: S
authors.lastname: Borson
mesh_terms: D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000639:trends; D019317:Evidence-Based Medicine / Q000379:methods* / Q000639:trends; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*
keywords: Parkinson's disease; electroconvulsive therapy; major depressive disorder