Electroconvulsive Therapy Improves Global Cognition in Bipolar Disorder

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Both general ECT and ultrabrief right unilateral ECT were also associated with significant improvements on the Young Mania Rating Scale.
Both general ECT and ultrabrief right unilateral ECT were also associated with significant improvements on the Young Mania Rating Scale.

Ultrabrief right unilateral electroconvulsive therapy (ECT) is effective in treating manic episodes and in improving global cognition for patients with bipolar disorder, according to findings published in the Journal of ECT.

Study data were collected using an "archival retrospective review" of cases treated by the Neurostimulation Service of the Institute of Mental Health in Singapore. Patients who had received ECT with concurrent antipsychotics for the treatment of mania (n=33) were assessed retroactively using the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale, and the Montreal Cognitive Assessment for symptom improvement after treatment. Researchers categorized data according to the type of ECT administered, focusing specifically on the effects of ultrabrief right unilateral ECT.

Among the study patients, 84% displayed improvements on the BPRS after ECT. Statistically significant improvements were observed in both overall BPRS scores (P <.01) and in BPRS Mania subscale scores (P <.01). Patients who underwent ultrabrief right unilateral ECT specifically displayed similar improvements on the BPRS overall (P <.001) and on the BPRS Mania subscale (P =.03). Both general ECT (P <.01) and ultrabrief right unilateral ECT (P <.01) were also associated with significant improvements on the Young Mania Rating Scale. According to the Montreal Cognitive Assessment, each treatment group showed improvements in global cognition during the treatment course (both P <.01).

These data confirm the efficacy of ECT in treating mania and indicate that ultrabrief right unilateral ECT specifically may be useful for improving the symptoms and global cognition of patients with bipolar disorder.

Reference

Wong VKH, Tor PC, Martin DM, Mok YM, Loo C. Effectiveness and cognitive changes with ultrabrief right unilateral and other forms of electroconvulsive therapy in the treatment of mania [published online June 26, 2018]. J ECT. doi:10.1097/YCT.0000000000000519

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