Electroconvulsive Therapy and Stroke in Affective Disorder

Peter M. Yellowlees, MBBS, MD


February 08, 2019

This transcript has been edited for clarity.

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

We know that electroconvulsive therapy (ECT) is a generally safe procedure, but the long-term risks of stroke are unknown. Now, a team of investigators from the University of Copenhagen, Denmark, have examined the association between ECT and risk for incident or recurrent stroke in a cohort of over 174,000 patients diagnosed with affective disorder between 2005 and 2016 in the Danish National Patient Registry.[1] The study included 5781 patients (3.6%) who were treated with ECT. The authors found that ECT was not associated with an elevated risk for incident or recurrent stroke.

What are the implications of this study? This is yet another study documenting the safety of ECT, which is without doubt the most effective and most underused treatment for depression that we have. Practitioners should not forget about ECT as a treatment for depression, especially in the elderly and in medically compromised patients, where the evidence is substantial that ECT is safer and leads to more rapid treatment responses than most of our medication regimens. The message from this study is, "Don't forget about ECT."

Thank you for listening to this Medscape Psychiatry Minute. Do continue to enjoy your practice.

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