Electroconvulsive Therapy Beyond Schizophrenia and Bipolar Disorders

Electroconvulsive therapy (ECT) has been in the limelight now for a century, yet it has been underutilized and under-rated as an effective treatment option in many neuropsychiatric conditions. Mostly, it has been considered as a treatment strategy to treat patients with treatment resistant schizophrenia as an augmentation strategy or in cases of severe manic agitation or bipolar depression. We review the research in the field of electroconvulsive therapy (ECT) on neurological and psychiatric conditions/disorders beyond schizophrenia and bipolar disorder.

Apart from schizophrenia and bipolar disorder, there is robust evidence on the efficacy and utility of ECT for treatment-resistant depression, catatonia due to functional or organic causes, suicidality, managing severe aggression in patients with dementia, treatment refractory obsessive–compulsive disorder, and neurological conditions like Parkinson’s disease and refractory epilepsy.

Research on ECT on conditions other than schizophrenia and bipolar disorder is well documented with proven efficacy in depression, catatonia, and suicidality. There is also a growing body of evidence of ECT in neuropsychiatric conditions like Parkinson’s disease, epilepsy, dementia, and also OCD. However, the research and clinical utility of ECT are still limited as compared to other brain stimulation techniques due to the stigma and attitude of patients as well as clinicians towards ECT. More well-designed controlled studies with larger sample size in all disorders where ECT has been shown to improve symptomatology are warranted to overcome the barriers to its use.