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Electroconvulsive Therapy in a Man With Comorbid Severe Obesity, Binge Eating Disorder, and Bipolar Disorder

Rapinesi, Chiara MD*†; Del Casale, Antonio MD; Serata, Daniele MD*†; Caccia, Federica MD*; Di Pietro, Simone MD*; Scatena, Paola MD*; Carbonetti, Paolo MD*; Fensore, Claudio MD*; Angeletti, Gloria MD; Tatarelli, Roberto MD; Kotzalidis, Georgios D. MD; Girardi, Paolo MD*†

doi: 10.1097/YCT.0b013e31827a7f85
Case Reports

A 41-year-old man with comorbid binge-eating disorder, severe obesity, and bipolar disorder since the age of 20 years, resistant to drug and psychotherapy combinations, worsened progressively. Relentless weight gain forced him to immobility and dependence on others. He was hospitalized for a mixed-mood episode with anxiety, mystical delusions, and auditory hallucinations. To overcome treatment resistance, we suggested electroconvulsive therapy. After 1 electroconvulsive therapy cycle, psychological symptoms promptly improved. He received clozapine and lithium. After 2 years, he reached normal weight and fair psychopathological compensation.

From the *Villa Rosa, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo; and †NESMOS Department (Neurosciences, Mental Health, and Sensory Functions), Sapienza University, 2nd Medical School, Sant’Andrea Hospital, Rome, Italy.

Received for publication July 14, 2012; accepted October 22, 2012.

Reprints: Antonio Del Casale, MD, NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University–Rome, Acute Psychiatric Care Unit, Sant’Andrea Hospital, Via di Grottarossa 1035-1039; 00189 Rome, Italy (e-mail:

This work has not been supported by any funding.

In the past 2 years, P.G. has received research support from Lilly, Janssen, and Springer Healthcare and has participated in advisory boards for Lilly, Otsuka, Pfizer, Schering, and Springer Healthcare and received honoraria from Lilly and Springer Healthcare. All other authors of this article have no relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the article. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

© 2013 by Lippincott Williams & Wilkins