ELECTROCONVULSIVE-THERAPY IN TREATMENT-RESISTANT BIPOLAR YOUTH

This study evaluates the apparent effectiveness and acute tolerability of electroconvulsive therapy (ECT) in adolescents and young adults wi th treatment-resistant acute bipolar episodes, Twenty-two rigorously e valuated and diagnosed adolescents were studied: 11 with acute mania a nd 11 with an acute depressive state, ECT treatment was agreed to by 1 6 of the patients and refused by 6 who elected to continue with standa rd pharmacologic inhospital care, The 16 ECT-treated patients underwen t a total of 166 individual ECT treatments, given using the brief puls e method at a dose of two treatments per week. Treatment outcome in th e ECT-treated group was significantly better than in the ECT-refusing group (p < 0.03), ECT treatment was associated with acute effects in 2 7% of the sample, Side effects were generally mild and mostly consiste d of headaches, The mean length of hospital stay in the ECT-treated gr oup was less than half that of the group who opted for continued pharm acotherapy (73.8 days compared to 176 days), and the cost per hospital ization in the ECT-treated group averaged about 60% less than for the ECT-refusing group ($58,608.00 compared to $143,264.00, Canadian dolla rs). These findings suggest that ECT may be a useful and cost-effectiv e treatment for severe acute manic and psychotic depressive states in bipolar adolescents.