alexa ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania | OMICS International | Abstract
ISSN: 2167-1044

Journal of Depression and Anxiety
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Research Article

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
Fax: 410-502-3755
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.

Abstract

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.

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