Certain Patients With Chronic Pain May Benefit from Electroconvulsive Therapy

Patients with chronic pain may be recommended for electroconvulsive therapy (ECT) if traditional treatments have not been effective, especially when comorbid mood symptoms are present, according to study results published in Pain Practice.

Investigators assessed the effects of ECT on pain severity and functional outcomes among patients with chronic pain.

A systematic review and case series were conducted, including adult patients who received chronic pain diagnoses more than 3 months before initiation of ECT.

Secondary outcomes were analyzed to determine if there was a connection between psychiatric improvement, specific pain diagnoses, demographic or medical characteristics, and variances in pain treatment response.

During the case series portion of the study, 11 cases of treatment with of ECT were identified among 9 women and 2 men with a mean age of 58.3 years. One patient identified as Black and 10 identified as White.

Of the 11 patients, 6 (54.5%) reported a decrease in their average pain levels according to the visual analog scale or based on follow-up notes recorded post-ECT treatment. Improvements in mood symptoms were reported among 90.9% of patients.

Side effects of the treatment included short-term memory deficits (9/11 patients) and increased intention tremors (1/11 patients). Of note, 4 patients reported baseline memory issues prior to treatment with ECT.

During the systematic review portion of the study, 22 studies published from 1975 to 2018 were identified and included 109 patients (60 women and 49 men) with a mean age of 55.2 years.

Post-ECT treatment, 78% (85 patients) of patients reported improvements in pain outcomes. Mood improvements were reported among 96.3% of the 80 patients with current psychiatric diagnoses.

This study was limited by inclusion of primarily case reports and case series without control groups, subjecting the data to potential publication bias and preventing comparison via quantitative analysis. Additionally, the majority of studies were conducted in the United States and Japan, reducing generalizability.

Study authors concluded, “This article aims to bring back the scientific community’s attention on this topic and to stimulate additional future studies. Certain pain diagnoses such as [complex regional pain syndrome], phantom limb pain, neuropathic pain, and low back pain have consistently reported benefits from ECT and should be preferentially studied in future studies with case-matched controls.”

This article originally appeared on Clinical Pain Advisor