Tags

Type your tag names separated by a space and hit enter

Efficacy and safety of electroconvulsive therapy in the first trimester of pregnancy: a case of severe manic catatonia.
Bipolar Disord. 2015 Aug; 17(5):567-71.BD

Abstract

OBJECTIVES

Electroconvulsive therapy (ECT) is an appropriate, albeit often neglected, option for managing severe or life-threatening psychiatric symptoms during pregnancy. We report on the rapid effectiveness and safety of ECT during the first trimester of pregnancy in a 28-year-old woman with severe catatonia.

METHODS

Catatonic symptoms were assessed using the Catatonia Rating Scale (CRS). The patient was treated with unilateral ECT using left anterior right temporal (LART) placement. Seizure quality and duration were monitored by a two-lead electroencephalograph (EEG) and by one-lead electromyography (EMG). During each ECT session, the fetal heart rate was monitored with electrocardiogram (ECG).

RESULTS

After the second ECT treatment (day 13 of hospitalization), we observed remission of the catatonic symptoms, as shown by the drop in the CRS score from 22 to 0. No cognitive abnormalities were reported and no gynecological complications were detected (e.g. vaginal bleeding, abdominal pain, or uterine contraction). The patient delivered at term a healthy male neonate who presented normal growth as well as normal psychomotor development.

CONCLUSIONS

This case highlights the effectiveness of ECT in treating severe catatonic mania during the first 3 months of pregnancy. In addition, ECT proved to be a safe therapeutic option, since neither mother nor infant experienced any adverse event. We suggest that ECT might be considered as a valid and safe option in the therapeutic decision-making process when catatonic symptoms manifest during pregnancy.

Authors+Show Affiliations

Psychiatry Unit, San Martino Hospital - Health Agency N. 5, Oristano, Italy.Psychiatry Unit, Department of Public Health, Molecular and Clinical Medicine, University of Cagliari, Cagliari, Italy. Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.Psychiatry Unit, San Martino Hospital - Health Agency N. 5, Oristano, Italy.Psychiatry Unit, San Martino Hospital - Health Agency N. 5, Oristano, Italy.Psychiatry Unit, San Martino Hospital - Health Agency N. 5, Oristano, Italy.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25854818

Citation

Pinna, Martina, et al. "Efficacy and Safety of Electroconvulsive Therapy in the First Trimester of Pregnancy: a Case of Severe Manic Catatonia." Bipolar Disorders, vol. 17, no. 5, 2015, pp. 567-71.
Pinna M, Manchia M, Pillai G, et al. Efficacy and safety of electroconvulsive therapy in the first trimester of pregnancy: a case of severe manic catatonia. Bipolar Disord. 2015;17(5):567-71.
Pinna, M., Manchia, M., Pillai, G., Salis, P., & Minnai, G. P. (2015). Efficacy and safety of electroconvulsive therapy in the first trimester of pregnancy: a case of severe manic catatonia. Bipolar Disorders, 17(5), 567-71. https://doi.org/10.1111/bdi.12297
Pinna M, et al. Efficacy and Safety of Electroconvulsive Therapy in the First Trimester of Pregnancy: a Case of Severe Manic Catatonia. Bipolar Disord. 2015;17(5):567-71. PubMed PMID: 25854818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of electroconvulsive therapy in the first trimester of pregnancy: a case of severe manic catatonia. AU - Pinna,Martina, AU - Manchia,Mirko, AU - Pillai,Gianluca, AU - Salis,Piergiorgio, AU - Minnai,Gian Paolo, Y1 - 2015/04/09/ PY - 2015/01/26/received PY - 2015/03/04/accepted PY - 2015/4/10/entrez PY - 2015/4/10/pubmed PY - 2016/3/10/medline KW - bipolar I disorder KW - catatonia KW - electroconvulsive therapy (ECT) KW - perinatal mental health KW - psychotic mania SP - 567 EP - 71 JF - Bipolar disorders JO - Bipolar Disord VL - 17 IS - 5 N2 - OBJECTIVES: Electroconvulsive therapy (ECT) is an appropriate, albeit often neglected, option for managing severe or life-threatening psychiatric symptoms during pregnancy. We report on the rapid effectiveness and safety of ECT during the first trimester of pregnancy in a 28-year-old woman with severe catatonia. METHODS: Catatonic symptoms were assessed using the Catatonia Rating Scale (CRS). The patient was treated with unilateral ECT using left anterior right temporal (LART) placement. Seizure quality and duration were monitored by a two-lead electroencephalograph (EEG) and by one-lead electromyography (EMG). During each ECT session, the fetal heart rate was monitored with electrocardiogram (ECG). RESULTS: After the second ECT treatment (day 13 of hospitalization), we observed remission of the catatonic symptoms, as shown by the drop in the CRS score from 22 to 0. No cognitive abnormalities were reported and no gynecological complications were detected (e.g. vaginal bleeding, abdominal pain, or uterine contraction). The patient delivered at term a healthy male neonate who presented normal growth as well as normal psychomotor development. CONCLUSIONS: This case highlights the effectiveness of ECT in treating severe catatonic mania during the first 3 months of pregnancy. In addition, ECT proved to be a safe therapeutic option, since neither mother nor infant experienced any adverse event. We suggest that ECT might be considered as a valid and safe option in the therapeutic decision-making process when catatonic symptoms manifest during pregnancy. SN - 1399-5618 UR - https://www.unboundmedicine.com/medline/citation/25854818/Efficacy_and_safety_of_electroconvulsive_therapy_in_the_first_trimester_of_pregnancy:_a_case_of_severe_manic_catatonia_ L2 - https://doi.org/10.1111/bdi.12297 DB - PRIME DP - Unbound Medicine ER -