Acute and Maintenance Electroconvulsive Therapy for Treatment of Psychotic Depression in a Pregnant Patient

Bozkurt, Ali; Karlıdere, Tunay; Işıntaş, Mehmet; Ozmenler, Nahit; Özşahin, Aytekin; Yanarateş, Ömer

doi:10.1097/yct.0b013e31806db4dd

Cited by 21 publications

(16 citation statements)

References 21 publications

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“…The electroconvulsive current does not pass through the uterus [69,70], and so other physiological and pathophysiological factors have to be considered as causes for this problem. Some studies propose that ECT can increase the risk of fetal and maternal cerebral hemorrhage and bronchospasm and cardiac events during pregnancy [71,72]. However, other authors disagree on this [73].…”

Section: Discussionmentioning

confidence: 96%

Electroconvulsive treatment during pregnancy: a systematic review

Pompili

Dominici

Giordano

et al. 2014

Expert Review of Neurotherapeutics

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Pharmacological treatment of severe psychiatric disorders during pregnancy is complicated by the potential harmful effects of treatment for the fetus. Electroconvulsive therapy (ECT) has been demonstrated to be effective for the treatment of several mental disorders. The aim of this study was to investigate the safety of ECT in the treatment of psychiatric disorders during pregnancy; to compare its efficacy with medication; and to identify the main indications for use in pregnancy. We performed a careful and systematic review of the literature on ECT and pregnancy was conducted. Almost all patients demonstrated total or at least partial remission of symptoms after ECT treatment. No deaths were reported in ECT-treated pregnant women. We conclude that ECT is probably currently under-used in many psychiatric settings because of its stigmatized perception by patients and by mental health professionals. ECT seems to be effective for treating major psychiatric disorders during pregnancy, and the risks of adverse events are low.

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Section: Discussionmentioning

confidence: 96%

Electroconvulsive treatment during pregnancy: a systematic review

Pompili

Dominici

Giordano

et al. 2014

Expert Review of Neurotherapeutics

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“…b Indicates ECT-related or ECT-linked adverse event. (14,40,45,52,57,60,61,65). Pinette and colleagues (68) recently reported on an infant whose mother underwent multiple rounds of ECT, the first being around the time of conception.…”

Section: Adverse Events Fetal Adverse Eventsmentioning

confidence: 97%

“…It has been suggested that ECT in pregnant patients increases the risk of fetal and maternal cerebral hemorrhage, and that ECT also increases the risk of bronchospasm and cardiac events during pregnancy (65,86). Most of these concerns have been refuted by the available evidence (87).…”

Section: Other Adverse Eventsmentioning

confidence: 97%

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ECT in Pregnancy: A Review of the Literature From 1941 to 2007

Anderson

Reti

2009

Psychosomatic Medicine

172

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Objective: To review the literature on the use of electroconvulsive therapy (ECT) during pregnancy and to discuss its risks and benefits for treating severe mental illness during pregnancy. Method: PubMed and PsycINFO databases were searched for English or English-translated articles, case reports, letters, chapters, and Web sites providing original contributions and/or summarizing prior data on ECT administration during pregnancy. Results: A total of 339 cases were found. The majority of patients were treated for depression and at least partial remission was reported in 78% of all cases where efficacy data were available. Among the 339 cases reviewed, there were 25 fetal or neonatal complications, but only 11 of these, which included two deaths, were likely related to ECT. There were 20 maternal complications reported and 18 were likely related to ECT. Conclusions: Although there are limited available data in the literature, it seems that ECT is an effective treatment for severe mental illness during pregnancy and that the risks to fetus and mother are low.

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“…5,6 In addition, the mother may be vulnerable to medication adverse effects related to the physiologic changes of pregnancy. 7 At the same time, it is known that untreated depression in pregnancy is associated with increased risks of poor maternal self care, 3 substance abuse, and premature labor. 2,4,8,9 Electroconvulsive therapy (ECT) has been used safely and effectively as a treatment of depression in all 3 trimesters of pregnancy.…”

mentioning

confidence: 99%

A Case of Delayed Onset of Threatened Premature Labor in Association With Electroconvulsive Therapy in the Third Trimester of Pregnancy

et al. 2010

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Electroconvulsive therapy (ECT) is recommended by the American Psychiatric Association Task Force on ECT as a safe and effective treatment of depression throughout pregnancy. We report here administration of ECT in the third trimester of pregnancy in a 33-year-old patient with severe bipolar depression. The patient had a good antidepressant response to ECT. She experienced, however, delayed onset premature uterine contractions at home after her sixth session of ECT (10 hours post-ECT administration). After receiving tocolytics, the patient's contractions did not progress to premature labor. In consultation with the obstetrics team, it was decided to terminate the ECT course earlier than planned. The patient is delivered of a healthy female newborn infant spontaneously at 37 weeks' gestational age. Four months after delivery, the baby's development is progressing normally. This case illustrates that premature contractions in association with ECT during the third trimester of pregnancy may be delayed in onset. Patients and treatment team need to be aware of this possibility, particularly when ECT is conducted on an outpatient basis.

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Acute and Maintenance Electroconvulsive Therapy for Treatment of Psychotic Depression in a Pregnant Patient

Cited by 21 publications

References 21 publications

Electroconvulsive treatment during pregnancy: a systematic review

Electroconvulsive treatment during pregnancy: a systematic review

ECT in Pregnancy: A Review of the Literature From 1941 to 2007

A Case of Delayed Onset of Threatened Premature Labor in Association With Electroconvulsive Therapy in the Third Trimester of Pregnancy

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