Author(s): Angst J, Angst K, Baruffol I, MeinherzSurbeck R
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Abstract In a retrospective chart study of 1,057 hospital admissions of endogenous depressives between 1920 and 1981, 139 patients (13\%) had received electroconvulsive therapy (ECT), and 12\% of them switched to hypomania. Within a subgroup of 524 psychotic unipolar depressives, 79 received ECT and eight (10\%) switched to hypomania, whereas among those not treated with ECT only 16 of 445 patients (3.6\%) switched to hypomania (p < 0.01). In psychotic bipolar patients the switch rates with and without ECT did not differ significantly (30\% vs. 32\%). Among untreated unipolar depressives hospitalized between 1920 and 1943, before the introduction of ECT or antidepressants, 3.9\% switched to hypomania. Among unipolar patients admitted after 1957 and treated by antidepressants 4\% switched to hypomania; among bipolar patients, 31\% switched to hypomania. We find no evidence for hypomania being induced by standard antidepressants. Without classifying depressive patients into manic and nonmanic based on the previous history, studies of drug-induced hypomania cannot be conclusive. These observations strongly support the hypothesis of an ECT-induced switch from depression to hypomania.
This article was published in Convuls Ther
and referenced in Journal of Depression and Anxiety