Although the data are limited, they suggest that ECT is relatively safe when administered during the first trimester of pregnancy. The possible adverse consequences of ECT during the first trimester of pregnancy should be carefully weighed against the potential benefits of ECT on untreated mental illness.

Objective The aim of this study was to determine the potential for safe and effective use of electroconvulsive therapy (ECT) in treating eating disorders (EDs) in patients with and without comorbid psychiatric disorders. Methods A review of the literature pertaining to the use of ECT in patients with EDs was performed through PubMed, PsycINFO, and MEDLINE. Search terms included “Electroconvulsive Therapy,” “ECT,” and “Electroshock” each combined with “Anorexia Nervosa,” “Bulimia Nervosa,” “Binge Eating Disorder,” “Eating Disorder,” “EDNOS,” and “OSFED.” Additionally, a case in which ECT was used in treating a patient with anorexia nervosa is presented. Results Eighty-nine articles were reviewed, and 11 were selected for inclusion. These articles detailed 14 patients with active EDs who received ECT during their course of treatment. Of these patients, 13 were noted to have shown improvement in disordered eating after receiving ECT, and no adverse medical outcomes were reported. Our case detailed an additional patient who benefitted from ECT. Conclusions There are limited data supporting the use of ECT in treating EDs; however, there is evidence to support that ECT is safe in this population and has been effective in cases of patients with AN with and without psychiatric comorbidities as well as binge eating disorder. More research is needed for treatment guidelines.

Objective This study reports on the use of electroconvulsive therapy (ECT) in neuropsychiatric symptoms (NPS) associated with COVID-19. Methods A review of the literature pertaining to the use of ECT in COVID-19 patients with NPS was performed through PubMed, PsycINFO, and MEDLINE. Search terms included “Electroconvulsive Therapy” and “ECT,” combined with “COVID-19” and “SARS-COV-2.” Additionally, we present a case in which ECT was used to achieve complete remission in a patient who developed new onset, treatment-resistant depression, psychosis, and catatonia, associated with COVID-19. Results 67 articles were reviewed with 3 selected for inclusion. These articles detailed 3 case reports of patients with new onset NPS (mania, psychosis and suicidality, and catatonia) that developed in the context of active COVID-19 and were treated successfully with ECT. Conclusions There is a significant prevalence of new onset NPS, some severe and persistent, in COVID-19 patients. ECT, a broad-spectrum treatment that has been found to be effective in various NPS (independent of etiology), is shown in our case report and others, to be safe and effective for NPS associated with COVID-19. Though we identified only 3 other cases in the literature, we believe that the probable anti-inflammatory mechanism of ECT, its safety and tolerability, and the faster time to symptom remission support the need for more research and increased clinician awareness about this life-saving procedure.

There are no US national laws on ECT leaving individual state governments to regulate treatment. Whereas some states have detailed restrictions on use, other states have no regulation at all. This variation applies to multiple areas of ECT practice, including who can receive ECT, who can provide informed consent, who can prescribe or perform ECT, and what administrative requirements (eg, fees, reporting) must be met by ECT practitioners. Knowledge of these state laws will help providers not only to be aware of their own state's regulations, but also to have a general awareness of what other states mandate for better patient care and utilization of ECT.

Objective: To inform obstetricians and psychiatrists about the safety of electroconvulsive therapy (ECT) administration during pregnancy and to reconcile conflicting recommendations concerning this treatment. Methods: A systematically conducted overview was undertaken on the safety of ECT during pregnancy. The Cochrane Library, MEDLINE/ PubMed, PsycINFO, and Ovid were independently searched by 2 of the authors from January 2015 to March 2017 using the following search terms: electroconvulsive therapy, ECT, and electroshock combined with pregnancy and reviews. Articles were reviewed and critically appraised using components of the PRISMA and AMSTAR systematic review assessment tools. Results: Of the 9 articles that were identified, 5 publications of varying methodological quality met inclusion criteria and involved a range of 32 to 339 patients. The most common problems that occurred in association with ECT were fetal arrhythmia, fetal bradycardia, premature birth, developmental delay, abdominal pain, uterine contraction, vaginal bleeding, placental abruption, and threatened abortion. The number of fetal deaths in each of the reviews ranged from 2 to 12. The authors of 1 of the 5 reviews recommended that ECT only be used as a last resort, whereas the authors of the other reviews took the stance that the administration of ECT during pregnancy was relatively safe. Differences in recommendations among reviews were in part due to inclusion criteria and how adverse events were attributed to ECT. Conclusions: Our overview supports the conclusion, which has also been endorsed by the American College of Obstetricians and Gynecologists and the American Psychiatric Association, that administration of ECT during pregnancy is relatively safe. Conclusions about safety, however, will become better established with the availability of more data.