Electroconvulsive therapy of depression in Alzheimer's disease. A case presentation of acute and maintenance electroconvulsive therapy

Depression and other neuropsychiatric symptoms are frequently reported in patients with dementia. These symptoms may seriously compromise the function and quality of life of demented patients. Both biologic and behavioral strategies are necessary in dealing with these problems. This article documents the efficacy of electroconvulsive therapy (ECT) in a 67-year-old woman with early-onset Alzheimer's disease. She developed severe depression that did not respond to drug therapy. Unilateral ECT was immediately effective, and she was given maintenance therapy with paroxetine. Two post-ECT relapses were effectively treated with further ECT series, and maintenance ECT was the most efficient prophylactic treatment. It is recommended that ECT is prescribed for demented patients with treatment refractory, severe depression.