Electroconvulsive Therapy for Depression in Transgender Patients

Abstract

There is very limited information regarding the effectiveness of electroconvulsive therapy (ECT) as a treatment for major depressive disorder in transgender patients. This population is also at risk for comorbid conditions, such as posttraumatic stress disorder and substance use that could impact the outcome of ECT. We report our experience with the use of ECT in this population. Clinical and response characteristics of 7 consecutive cases are described in this series. All patients had multiple psychiatric diagnoses and were refractory to pharmacologic intervention. Pretreatment Beck Depression Inventory-II scores were 45.5 ± 3.2 SEM and posttreatment scores were 21.2 ± 6.4 [P < 0.01]. Suicidality scores reduced by greater than 60%, whereas remission of depression was obtained for 2 of 7, and 4 of 7 showed greater than 50% reduction in depression scores. Treatments were tolerated well using conventional treatment procedures. This case series suggests that ECT can be effective for depressed transgender patients with multiple clinical comorbidities.

A scoping review of suicide prevention initiatives for sexual and gender minority people.

“…M. Diamond et al, 2012;Grannis et al, 2021;Pachankis, Williams, et al, 2020;Russon, Morrissey, et al, 2022;Saewyc et al, 2014;Turban et al, 2020;van der Miesen et al, 2020;Wang et al, 2013), including four therapeutic interventions (G. M. Diamond et al, 2012;Pachankis, Williams, et al, 2020;Russon, Morrissey, et al, 2022), and four gender-affirmative treatments (Achille et al, 2020;Grannis et al, 2021;Turban et al, 2020;van der Miesen et al, 2020). Other interventions (n = 4) provided standard treatment un-modified for SGM people (Beard et al, 2017;Mormando, et al, 2021;Plöderl et al, 2017;Zhang et al, 2020). Lastly, only three studies assessed the longer-term (3-18 months) outcome of the interventions (Achille et al, 2020;Pachankis, Williams, et al, 2020).…”

“…Five studies assessed biological and medically based treatments, including one study that assessed electroconvulsive therapy, and four that examined the impact of hormonal treatments, all five focused on GM people. Mormando et al (2021) examined the effect of electroconvulsive therapy on major depressive disorder in seven trans-identifying people. Suicidal ideation was measured using a single item from the Beck depression inventory-II (Beck et al, 1996).…”

Transcranial Direct Current Stimulation for Depression in Transgender Patient

“…With the very recent exception of electroconvulsive therapy (ECT), neuromodulation in TGD patients is not addressed in the literature [7][8][9][10][11]. Yet, compared to others, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients are more likely to have histories of trauma, self-harm, and substance abuse [1].…”

Electroconvulsive Therapy in Transgender and Gender Diverse Population: A Case Report and Review of Literature

“…Luccarelli et al [ 13 ] found a reduction in depressive symptoms as measured by the Quick Inventory of Depressive Symptomatology in 19 patients with a mix of MDD and bipolar affective disorder. Similarly, Oka et al [ 14 ] found a significant clinical improvement comparable to a control sample of non-LGBTQ patients receiving ECT, while Mormando et al [ 15 ] outlined six patients with multiple psychiatric diagnoses who were refractory to pharmacologic intervention while receiving GAHT. In keeping with the two aforementioned case series, they found ECT helped improve depressive symptomatology (using Beck Depression Inventory) and observed a reduction in suicidality.…”