When Obsessive Compulsive Disorder Responds Only to Electroconvulsive Therapy: A Rare Case for Maintenance Electroconvulsive Therapy?

Agrawal, Adesh Kumar; Das, Soumitra; Thirthalli, Jagadisha

doi:10.4103/jnrp.jnrp_12_18

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…The only cohort study of ECT was a retrospective review reporting a mean symptom improvement of 42% following treatment, and 35% improvement 12 months later [38]. Pooled together, the case studies for OCD revealed a response rate of 79% (11/14); within those who responded, symptom improvement of 43-95% was achieved [39][40][41][42][43].…”

Section: Ect Results For Ocdmentioning

confidence: 99%

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Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review

et al. 2021

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Invasive and noninvasive neurostimulation therapies for obsessive-compulsive and related disorders (OCRD) were systematically reviewed with the aim of assessing clinical characteristics, methodologies, neuroanatomical substrates, and varied stimulation parameters. Previous reviews have focused on a narrow scope, statistical rather than clinical significance, grouped together heterogenous protocols, and proposed inconclusive outcomes and directions. Herein, a comprehensive and transdiagnostic evaluation of all clinically relevant determinants is presented with translational clinical recommendations and novel response rates. Electroconvulsive therapy (ECT) studies were limited in number and quality but demonstrated greater efficacy than previously identified. Targeting the pre-SMA/SMA is recommended for transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). TMS yielded superior outcomes, although polarity findings were conflicting, and refinement of frontal/cognitive control protocols may optimize outcomes. For both techniques, standardization of polarity, more treatment sessions (>20), and targeting multiple structures are encouraged. A deep brain stimulation (DBS) ‘sweet spot’ of the striatum for OCD was proposed, and CBT is strongly encouraged. Tourette’s patients showed less variance and reliance on treatment optimization. Several DBS targets achieved consistent, rapid, and sustained clinical response. Analysis of fiber connectivity, as opposed to precise neural regions, should be implemented for target selection. Standardization of protocols is necessary to achieve translational outcomes.

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Section: Ect Results For Ocdmentioning

confidence: 99%

“…In one study [41], three out of five patients were responders following treatment; only one remained a responder at 3-and 6-month follow-up, according to the clinical global impression (CGI) scale (not YBOCS). Another patient relapsed to baseline twice following consecutive cycles of ECT [42].…”

Section: Ect Results For Ocdmentioning

confidence: 99%

Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review

et al. 2021

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“…Due to this, ECT has a certain effect on OCD patients, but it has a less significant effect on refractory patients. The use of ECT has also been associated with significant improvements in refractory OCD in many cases (24)(25)(26)(27)(28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive therapy for obsessive-compulsive disorder: A retrospective study

Long

Deng

et al. 2022

Front. Psychiatry

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BackgroundChronic mental diseases such as obsessive-compulsive disorder (OCD) are associated with a high disability rate. Some patients still do not improve their symptoms even with adequate cognitive-behavioral therapy and drug treatment. In the treatment of OCD, electroconvulsive therapy (ECT) is not considered a neuromodulation modality with sufficient evidence.ObjectiveThis retrospective study aimed to determine the efficacy and associated risk factors of ECT in OCD patients.Materials and methodsThe study included 21 OCD patients who underwent ECT at a high-volume center in China between January 2009 and December 2020. The demographics and clinical characteristics of the patients were assessed using descriptive statistics. Based on Clinical Global Impressions–Improvement scale, patients were categorized into response and non-response groups. Clinical and demographic characteristics of two groups of patients were compared.ResultsAn analysis of 21 patients was conducted. In total, 12 patients (57.1%) responded to ECT, 11 patients (52.4%) reported side effects, and an average of 7 ECT sessions were administered. In terms of demographic, there was no statistically significant difference between the two groups. It is noteworthy that the non-response group reported more depression and schizophrenia related disorders comorbidities than the response group (χ2 = 6.252, P = 0.041).ConclusionThe effectiveness of ECT in treating OCD is limited, especially in patients with refractory symptoms. Comorbidity with other mental disorders may affect the efficacy of ECT.

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“…A short case study described a 65‐year‐old female with depression, OCD and anorexia who achieved full remission of her OCD symptoms with ECT 18 . The final case study discussed an 18‐year‐old male with refractory OCD who responded well to ECT, deteriorating soon after this was stopped, but improving again once treatment was restarted 19 …”

Section: Methodsmentioning

confidence: 99%

“…18 The final case study discussed an 18-year-old male with refractory OCD who responded well to ECT, deteriorating soon after this was stopped, but improving again once treatment was restarted. 19 Electroconvulsive therapy for refractory anxiety disorders Ahmed Saeed Yahya MBBS, MA, MRCPsych, Shakil Khawaja MBBS, MRCPsych Anxiety disorders, particularly obsessive compulsive disorder and other related disorders, can be crippling and can cause significant distress and impairment. They may be very difficult to treat and some cases can also be life threatening.…”

Section: Methodsmentioning

confidence: 99%

Electroconvulsive therapy for refractory anxiety disorders

Yahya

Khawaja

2021

Prog Neurol Psychiatry

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When Obsessive Compulsive Disorder Responds Only to Electroconvulsive Therapy: A Rare Case for Maintenance Electroconvulsive Therapy?

Cited by 5 publications

References 2 publications

Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review

Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review

Electroconvulsive therapy for obsessive-compulsive disorder: A retrospective study

Electroconvulsive therapy for refractory anxiety disorders

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