When is electroconvulsive therapy (ECT) recommended by the VA/DoD for primary treatment of bipolar affective disorder (manic-depressive illness)?

Updated: May 30, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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The 2010 Department of Veterans Affairs/Department of Defense (VA/DoD) clinical practice guideline for management of bipolar disorder indicates ECT is the primary therapy in bipolar disorder patients that present with psychotic symptoms, catatonia, severe suicidality, food refusal leading to nutritional compromise, or who have a history of previous positive response to ECT. [3] Indeed, in a review of 50 years’ experience with ECT for acute manic episodes, data from early literature revealed that 313 of 400 patients with acute mania who received ECT showed significant clinical improvement. [111]

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