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The Safety of Electroconvulsive Therapy and Lithium in Combination: A Case Series and Review of the Literature

Dolenc, Tamara J MD; Rasmussen, Keith G MD

doi: 10.1097/01.yct.0000174383.96517.77
Original Article

Early reports cautioned against the combination of lithium and electroconvulsive therapy (ECT), citing risk of excessive cognitive disturbance, prolonged apnea, and spontaneous seizures. However, recent case series with larger numbers of patients indicate that the combination may be used safely and with optimal efficacy in certain clinical circumstances. In this report, we describe 12 patients in whom the combination of lithium and ECT was deemed safe. We also provide a comprehensive review of published literature and provide detailed recommendations for clinical practice.

From the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

Received for publication March 10, 2005; accepted June 9, 2005.

Reprints: Keith G. Rasmussen, MD, Mayo Clinic Department of Psychiatry and Psychology, Mayo West 11, 200 First St. SW, Rochester, MN 55905 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.