Electroconvulsive therapy for depression in Parkinson's disease: systematic review of evidence and recommendations
Abstract
Aim: We performed a systematic review of evidence regarding treatment of depression in Parkinson's disease (PD) utilizing electroconvulsive therapy. Methods: The search led to the inclusion of 43 articles, mainly case reports or case series, with the largest number of patients totaling 19. Results: The analysis included 116 patients with depression and PD; depression improved in 93.1%. Where motor symptoms’ severity was reported, 83% of patients improved. Cognition did not worsen in the majority (94%). Many patients experienced delirium or transient confusion, sometimes necessitating discontinuation of electroconvulsive therapy (ECT). Little is known about maintenance ECT in this population. Conclusion: ECT can benefit patients suffering from PD and depression. We recommend an algorithm for treatment of depression in PD, utilizing ECT sooner rather than later.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
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