Role of Electroconvulsive Therapy in Major Depressive Disorder with Borderline Personality Disorder: Case Report and Literature Review

Wasiq, Saad; Khan, Ahmad R; Faquih, Amber Ehsan; Saeed, Hina; Mahmood, Hafsa

doi:10.7759/cureus.3211

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…Similar to the patient described in this case report, Wasiq et al obtained a significant improvement in the clinical condition of a patient, suffering from depressive disorders and BPD, who had been unsuccessfully treated with pharmacotherapy and psychotherapy for 10 years, indicating the need for further research in this area [7].…”

Section: Discussionsupporting

confidence: 78%

“…Współchorobowość w przebiegu zaburzeń depresyjnych jest duża; szacuje się, że w 40% towarzyszą im zaburzenia osobowości, a w 20% zespół uzależnienia od alkoholu [6]. Kolejne badania wskazują na współchorobowość sięgającą od 30 do 80% [7].…”

Section: Wstępunclassified

“…Podobnie jak w przypadku opisanej w tym artykule pacjentki, Wasiq wsp. uzyskali istotną poprawę stanu klinicznego pacjenta, chorującego na zaburzenia depresyjne i BPD, który od 10 lat był bezskutecznie leczony za pomocą farmakoterapii i psychoterapii, wskazując na potrzebę dalszych badań w tym zakresie [7].…”

Section: Opis Przypadkuunclassified

“…Comorbidity in the course of depressive disorders is high; it is estimated that 40% are accompanied by personality disorders and 20% by alcohol dependence syndrome [6]. Subsequent studies indicate co-morbidity ranging from 30 to 80% [7].…”

Section: Introductionmentioning

confidence: 99%

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Can electrical interventions be helpful in treating mood disorders in patients diagnosed with personality disorders? Case report and literature review.

Stelmach

2022

Current Problems of Psychiatry

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Introduction: The main indication for electrical interventions remains mood disorders. Depressive disorders have high comorbidity, which is one factor in poorer remission and higher suicide risk. Borderline personality disorder is characterized by a variety of psychopathology, in particular the presence of mood swings, impulsive behaviour, and difficulties in maintaining stable interpersonal relationships. An extremely serious clinical problem is the occurrence of episodes of self-harm and suicidal behaviour in these patients. Comorbidity in affective disorders increases the risk of suicide and also reduces the likelihood of achieving symptomatic remission. Material and methods: A case report of a patient with a major depressive episode and suicidal tendencies with coexisting borderline personality disorder who received electrical treatments with good results is presented and literature from the last 10 years is reviewed using the keywords: borderline personality disorder, depression, electroconvulsive therapy, suicide. Results: The results of several studies indicate that electrical treatments are partially effective in patients suffering from depressive disorders and borderline personality disorder. Conclusions: The case of the patient described, as well as data from the literature, suggest that further research is needed into the use of electrical interventions in patients with mood disorders and comorbidity, and their use may be considered in them as a potentially good therapeutic method. The use of ECT in a patient with comorbid personality disorder reflects an individualized treatment approach; however, there is a need for further research in this area, especially in the context of long-term treatment effects.

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Section: Discussionsupporting

confidence: 78%

Section: Wstępunclassified

Section: Opis Przypadkuunclassified

Section: Introductionmentioning

confidence: 99%

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Can electrical interventions be helpful in treating mood disorders in patients diagnosed with personality disorders? Case report and literature review.

Stelmach

2022

Current Problems of Psychiatry

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“…8 Ketamine, an N-methyl-D-aspartic acid receptor antagonist, may provide additional benefits for ECT in patients with major depression owing to its independent antidepressant effect. [9][10][11] Although the efficacy of ketamine as a first-line anesthetic for ECT has been inconsistent and controversial in randomized controlled trials (RCTs), [12][13][14][15] a meta-analysis has shown that ketamine induces a longer seizure duration than other anesthetics, including propofol, thiopental, and methohexital. 16 Therefore, ketamine may improve the quality of seizures that maybe short or difficult to induce using other anesthetics.…”

Section: Discussionmentioning

confidence: 99%

Ketamine as an Alternative Anesthetic for Augmenting Seizure Durations During Electroconvulsive Therapy

Mutoh,

Kinoshita,

Maeda

et al. 2023

J ECT

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Objective Electroconvulsive therapy (ECT) is highly effective for severe psychiatric disorders; however, short seizure durations may lead to ineffective therapy. This retrospective study aimed to examine the risks and benefits of switching to ketamine anesthesia to augment seizure durations during an acute course of ECT. Methods We included 33 patients who underwent ketamine anesthesia due to suboptimal seizures during an acute course of ECT. We assessed seizure duration, stimulus dose, hemodynamic variability, and postseizure complications before and after switching to ketamine. Results Age was significantly associated with suboptimal seizures during ECT (P = 0.040). After switching to ketamine, 32 patients (97%) experienced prolonged seizure duration. Ketamine significantly prolonged both electroencephalogram and motor seizure durations with a mean difference of 34.6 seconds (95% confidence interval [CI], 26.4–42.7 seconds; P < 0.001) and 26.6 seconds (95% CI, 19.6–33.6 seconds; P < 0.001), respectively. It also significantly reduced stimulus dose (mean difference, −209.5 mC [95% CI, −244.9 to −174.1 mC]; P < 0.001). In addition, maximum changes in systolic blood pressure and heart rate during ECT sessions significantly increased with ketamine (mean difference, 27.2 mm Hg [95% CI, 12.0–42.4 mm Hg; P = 0.001]; 25.7 beats per minute [95% CI, 14.5–36.8 beats per minute; P < 0.001], respectively). Patients reported more headaches with ketamine (P = 0.041). Conclusions Our results provide evidence that ketamine as an alternative anesthetic can augment seizure durations in specific patients experiencing suboptimal seizures during an acute course of ECT. However, its use requires greater attention to circulatory management and postseizure complications.

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Efficacy and tolerability of Brain Stimulation interventions in Borderline Personality Disorder: state of the art and future perspectives – A systematic review

Lisoni

Barlati

Deste

et al. 2022

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Role of Electroconvulsive Therapy in Major Depressive Disorder with Borderline Personality Disorder: Case Report and Literature Review

Cited by 5 publications

References 17 publications

Can electrical interventions be helpful in treating mood disorders in patients diagnosed with personality disorders? Case report and literature review.

Can electrical interventions be helpful in treating mood disorders in patients diagnosed with personality disorders? Case report and literature review.

Ketamine as an Alternative Anesthetic for Augmenting Seizure Durations During Electroconvulsive Therapy

Efficacy and tolerability of Brain Stimulation interventions in Borderline Personality Disorder: state of the art and future perspectives – A systematic review

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