A Case Report of Successful Electroconvulsive Therapy for Severe Delirium in a Patient with Bipolar Disorder
Nien-Mu Chiu, Ellen Yu-Lun TsengAbstract
Background:
The benefit of electroconvulsive therapy (ECT) in treating patients with delirium and bipolar disorder is rarely published. A delirious state often makes the decision of using ECT as a treatment choice more hesitant. We report a rare case of a patient with both issues here.
Case Report:
A 48-year-old married female patient had a history of previous four hospitalizations for bipolar depressive disorder without previous ECT. In this hospitalization, she was hospitalized for worsen depressive symptoms. But the mood condition was shifted to severe delirium with repeated falls despite medication modifications and abdominal restraint during hospitalization. Finally, she received ECT once daily for six days with improved symptoms right after the treatment and when she was seen at the clinic follow-up in six months.
Conclusion:
A patient with mood symptoms with concomitant delirium need to be fully evaluated for possible organic causes. Psychiatrists should also keep in mind of a possible ECT benefit of treating delirium after careful evaluation for organic causes.