Original ArticlesECT in Mixed Affective States: A Case SeriesGruber, Nelson P. M.D; Dilsaver, Steven C. M.D; Shoaib, Arif M. M.D; Swann, Alan C. M.DAuthor Information UT–Harris County Psychiatric Center, Department of Psychiatry and Behavioral Sciences, The University of Texas–Houston Health Sciences Center (UT-HHSC), Houston, Texas, U.S.A. Dr. S. C. Dilsaver was formerly Professor of Psychiatry at the Department of Psychiatry and Behavioral Sciences, UT–HHSC. He is currently at the Department of Medicine, Providence Hospital of the Sisters of St. Francis, Sandusky, Ohio. Dr. A. M. Shoaib is a former Research Fellow in the Department of Psychiatry and Behavioral Sciences, UT–HHSC. He is currently Resident at the Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas. Received June 15, 1998; accepted April 29, 1999. Address correspondence and reprint requests to Dr. N. P. Gruber, UT–Harris County Psychiatric Center 2D-08, 2800 South Macgregor Way, Houston, Texas 77021, U.S.A. The Journal of ECT: June 2000 - Volume 16 - Issue 2 - p 183-188 Buy Abstract There is limited information regarding the effectiveness of electroconvulsive therapy (ECT) as a treatment for patients in a mixed affective state. The authors report their experience using this treatment in medication-resistant patients meeting Research Diagnostic Criteria (RDC) for both mania and major depression. Clinical and response characteristics of these patients are described. Forty-one consecutively admitted patients meeting the RDC for mania received pharmacotherapy. Eight patients failing to respond to pharmacotherapy were referred for ECT, and seven consented. All met RDC for both mania and major depressive disorder. All patients receiving ECT remitted. The patient who did not accept ECT did not improve and ultimately needed transfer to a state hospital for longer term care. Mixed manic-depressive states are responsive to ECT, even in medication-refractory patients. © 2000 Lippincott Williams & Wilkins, Inc.