ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania
|Emily Bost-Baxter, Irving M Reti and Jennifer L Payne*|
|Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Broadway, Suite 305, Baltimore, MD 21205, USA|
|*Corresponding Author :||Jennifer L Payne
Department of Psychiatry and Behavioural sciences
Johns Hopkins School of Medicine
550 N Broadway, Suite 305
Baltimore, MD 21205, USA
E-mail: [email protected]
|Received October 01, 2012; Accepted October 23, 2012; Published October 26, 2012|
|Citation: Bost-Baxter E, Reti IM, Payne JL (2012) ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania. J Depress Anxiety 1:123. doi:10.4172/2167-1044.1000123|
|Copyright: © 2012 Bost-Baxter E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Electroconvulsive Therapy (ECT) is an effective treatment for bipolar depression. However, it remains unclear how often patients with bipolar disorder who are receiving ECT “switch” from a depressed to a hypomanic or manic state. Our objective was to determine the switch rate in a sample of inpatients with bipolar disorder who received ECT, and to determine which clinical variables were associated with a greater likelihood of switch.
Methods: We performed a retrospective chart review of 100 inpatients treated with ECT for a depressive episode who had a diagnosis of bipolar disorder type I or II. We determined the incidence of switch into hypomania or mania and the impact of clinical features and ECT treatment variables on switching.
Results: The incidence of switch in our sample was 24.8%. Diagnosis, concurrent antidepressant medications, lack of the use on an antimanic agent, and a history of rapid cycling were not associated with an increased risk of switch. In a subset of patients who were not taking anti-manic medications during ECT, switch was associated with receiving a higher number of ECT treatments (p=0.02).
Conclusions: A quarter of all patients with bipolar disorder switched from a depressive episode into hypomania or mania with administration of ECT. Psychiatrists should be alert to the substantial risk of mood switching when treating bipolar depression with ECT.