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Electroconvulsive Therapy for Depression Comorbid With Myasthenia Gravis

A Case Report and Review of the Literature

Warren, Mark B. MD*; Elder, Scott CRNA, MAE; Litchfield, Norman P. MD*

doi: 10.1097/YCT.0000000000000446
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Objectives Myasthenia gravis (MG) is a rare but well-described autoimmune disease, which is sometimes comorbid with psychiatric illness. There have been several case reports describing the use of electroconvulsive therapy (ECT) for the treatment of core psychopathology in the context of MG. We sought to review the available published data on ECT in MG and add another case example to the literature.

Methods We performed a PubMed search for relevant articles or case reports in English describing ECT in MG and summarized findings.

Results We identified 7 published cases meeting our inclusion criteria in varying detail with different psychiatric presentations and different anesthetic and ECT technique approaches. In addition, we add our own case.

Conclusions Based on the literature and our own clinical experience, ECT seems to be a safe option for the treatment of core psychopathology with comorbid MG as long as appropriate precautions are in place, particularly when choosing an anesthetic approach.

From the *Department of Psychiatry, Boise Veterans Administration Medical Center, University of Washington; and †Department of Anesthesia, Boise Veterans Administration Medical Center, Boise, ID.

Received for publication May 23, 2017; accepted July 9, 2017.

Reprints: Mark B. Warren, MD, Boise Veterans Administration Medical Center, University of Washington, 500 W Fort St, Boise, ID 83702 (e-mail: mark.warren@va.gov).

The authors have no conflicts of interest or financial disclosures to report.

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