Contraindications of Electroconvulsive therapy

What are the Contraindications of Electroconvulsive therapy? 

There are no absolute contraindications for Electroconvulsive therapy.

Relative contraindications include increased intracranial pressure (mass effect), recent intracranial hemorrhage, thromboembolic stroke, or myocardial infarction, unstable angina, heart failure, or vertebral fracture.

Electroconvulsive therapy is safe in pregnancy and may be preferred to pharmacotherapy in this setting.

Electroconvulsive therapy is safe in epilepsy, and the use of ECT as a treatment for refractory status epilepticus has been described in case reports. 

Sources

  • Fava M, Østergaard SD, Cassano P: Mood disorders: depressive disorders (major depressive disorder). In Stern TA, Fava M, Wilens TE, Rosenbaum JF (eds): Massachusetts General Hospital comprehensive clinical psychiatry. London: Elsevier, 2016, p 327. 
  • Fava M, Østergaard SD, Cassano P: Mood disorders: depressive disorders (major depressive disorder). In Stern TA, Fava M, Wilens TE, Rosenbaum JF (eds): Massachusetts General Hospital comprehensive clinical psychiatry. London: Elsevier, 2016, p 324. 
  • Levy ML, Cummings JL, Fairbanks LA, et al.: Apathy is not depression. J Neuropsychiatry Clin Neurosci 10(3):314-319, 1998. 
  • Sadock BJ, Sadock VA, Belkin GS (eds): Kaplan & Sadock’s pocket handbook of clinical psychiatry, 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2010, pp 190-194. 
  • George MS, Taylor JJ, Short EB, et al.: Brain stimulation treatments for mood disorders. In Gabbard GO (ed): Gabbard’s treatments of psychiatric disorders. Washington, DC: American Psychiatric Publishing, 2014, pp 303-337. 
  • Welch CA: Electroconvulsive therapy. In Stern TA, Fava M, Wilens TE, Rosenbaum JF (eds): Massachusetts General Hospital comprehensive clinical psychiatry. London: Elsevier, 2016, pp 510-512. 
  • Lunde ME, Lee EK, Rasmussen KG: Electroconvulsive therapy in patients with epilepsy. Epilepsy Behav 9(2):355-359, 2006.
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