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Electroconvulsive therapy: an effective therapy of medication-resistant bipolar disorder


  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Pascal Sienaert, MD, University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. Fax: 0032 2 759 53 80; e-mail:


Objectives:  We report our experience with a medication-refractory patient with bipolar I disorder, who remained clinically stable under continuation electroconvulsive therapy (C-ECT). We found ECT to be effective in providing functionality for a patient when various medications had failed.

Methods and results:  A 53-year-old woman with a 31-year history of recurrent manic and depressive episodes poorly responsive to medications warranted an ECT trial. Remission was achieved after 12 treatments and C-ECT at weekly intervals was used as maintenance therapy. C-ECT was continued for 37 months and 85 treatments, and discontinued when anesthetic difficulties precluded further treatment. Three months after the last ECT, she was readmitted in a severe manic relapse. Restarting ECT caused rapid remission. There are no signs of cognitive deterioration during C-ECT.

Conclusion:  Long-term C-ECT is an effective and safe prophylactic treatment in individual treatment-resistant patients with bipolar disorder.