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Bipolar disorder in adults: Indications for and efficacy of electroconvulsive therapy (ECT)

Charles Kellner, MD
Section Editor
Paul Keck, MD
Deputy Editor
David Solomon, MD


Patients treated with electroconvulsive therapy (ECT) receive general anesthesia and muscle relaxation, followed by a small electric current administered to the scalp to produce a generalized cerebral seizure. ECT is a standard treatment for unipolar major depression; it is also used for bipolar major depression and less commonly for mania and bipolar mood episodes with mixed features. Indications for ECT include failure to respond to multiple antidepressant medication trials, or acute illness (eg, severe suicidality) that requires a rapid and definitive response. A course of ECT typically consists of 6 to 12 treatments given two or three times per week.

This topic reviews the indications and efficacy of ECT for bipolar disorder. Separate topics provide an overview of ECT (including pre-ECT evaluation, use of concurrent medications, treatment course, and adverse effects), and discuss the indications for and efficacy of ECT in unipolar major depression, the medical consultation for ECT, and the technique for performing ECT.

(See "Overview of electroconvulsive therapy (ECT) for adults".)

(See "Unipolar major depression in adults: Indications for and efficacy of electroconvulsive therapy (ECT)".)

(See "Medical consultation for electroconvulsive therapy".)


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Literature review current through: Sep 2016. | This topic last updated: Oct 4, 2016.
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