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Use of Continuation or Maintenance Electroconvulsive Therapy in Adolescents With Severe Treatment-Resistant Depression

Ghaziuddin, Neera MD, MRCPsych; Dumas, Sara MD; Hodges, Elise PhD

doi: 10.1097/YCT.0b013e3181f665e4
Case Reports

Retrospective data are presented for 6 adolescents ranging in age from 14 to 17 years, who were diagnosed with severe treatment-resistant major depression (TRD). Subjects were treated with one or more index courses of electroconvulsive therapy (ECT) followed by continuation ECT (C-ECT, up to 6 months of ECT) or maintenance ECT (M-ECT; ECT beyond 6 months) when necessary. Electroconvulsive therapy was continued until remission or until minimal residual symptoms were evident. Pharmacotherapy and psychotherapy were reintroduced during C-ECT or M-ECT. Premorbid functioning was achieved by 5 of 6 cases. Cognitive deficits were not evident. In fact, comparison of pre-ECT and post-ECT neuropsychological functioning revealed a trend toward improved auditory and verbal memory on most of the results. We concluded that C-ECT and M-ECT are useful and safe treatment strategies for selected adolescents with severe treatment-resistant depression, and symptom remission may be achieved without experiencing cognitive impairment.

From the Department of Psychiatry, University of Michigan, Ann Arbor, MI.

Received for publication May 11, 2010; accepted July 23, 2010.

Reprints: Neera Ghaziuddin, MD, MRCPsych, 4250 Rachel Upjohn Building, Plymouth Rd, Ann Arbor, MI 48109 (e-mail: neerag@umich.edu).

© 2011 Lippincott Williams & Wilkins, Inc.