We report a positive response to electroconvulsive therapy in a severely functionally impaired adolescent with autistic disorder and classic bipolar I disorder, including an episodic pattern of decreased need for sleep, hypersexuality, expansive and agitated affect, aggression, self-injury, and property destruction.
After ineffective trials of mood stabilizers and antipsychotics as well as inability to sustain a positive response to lithium due to medication noncompliance, a course of acute and maintenance electroconvulsive therapy was attempted.
A marked and sustained improvement across all symptom categories, as measured by directly observed frequency counts of target behaviors in an inpatient setting, was obtained.
Electroconvulsive therapy should be considered a potentially useful intervention in cases of children with autistic disorder and a severe comorbid affective disorder.
From the *Spring Harbor Hospital, Westbrook, ME and †Maine Medical Center, Portland, ME.
Received for publication March 16, 2012; accepted April 27, 2012.
Reprints: Matthew Siegel, MD, Developmental Disorders Program, Spring Harbor Hospital, 123 Andover Road, Westbrook, ME 04092 (e-mail: firstname.lastname@example.org).
The Pond Family Foundation and the Maine Medical Center Research Institute provided general support for this work.
The authors have no conflicts of interest or financial disclosures to report.