uestion: Is there an urgent indication for electroconvulsive therapy (ECT)?

Help: Urgent indications may include (but are not limited to) severe states of suicidality, inanition, catatonia, psychosis, or incapacitating depression in the context of certain medical conditions or pregnancy.¹

¹Coffey CE. The pre-ECT evaluation. Psychiatric Annals 1998;28:506-508.

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Recommendation:

Electroconvulsive therapy may be the first line and most effective treatment for severe psychotic or non-psychotic bipolar depression.¹ However, this may not be acceptable to the patient or the clinicians, or a practical option under some circumstances.

If this option is unacceptable, or has already been tried without success, click here to continue with the algorithm.

Recommendation #46

¹Zornberg GL, Pope HG Jr. Treatment of depression in bipolar disorder: new directions for research. J Clin Psychopharmacol 1993;13:397-408. Goodwin FK, Jamison KR. Manic Depressive Illness. New York: Oxford University Press; 1990.