Electroconvulsive therapy in an adolescent with autism and bipolar I disorder

J ECT. 2012 Dec;28(4):252-5. doi: 10.1097/YCT.0b013e31825cec86.

Abstract

Objectives: We report a positive response to electroconvulsive therapy in a severely functionally impaired adolescent with autistic disorder and classic bipolar I disorder, including an episodic pattern of decreased need for sleep, hypersexuality, expansive and agitated affect, aggression, self-injury, and property destruction.

Methods: After ineffective trials of mood stabilizers and antipsychotics as well as inability to sustain a positive response to lithium due to medication noncompliance, a course of acute and maintenance electroconvulsive therapy was attempted.

Results: A marked and sustained improvement across all symptom categories, as measured by directly observed frequency counts of target behaviors in an inpatient setting, was obtained.

Conclusions: Electroconvulsive therapy should be considered a potentially useful intervention in cases of children with autistic disorder and a severe comorbid affective disorder.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aggression / psychology
  • Antimanic Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Autistic Disorder / complications
  • Autistic Disorder / psychology
  • Autistic Disorder / therapy*
  • Behavior
  • Bipolar Disorder / complications
  • Bipolar Disorder / psychology
  • Bipolar Disorder / therapy*
  • Electroconvulsive Therapy*
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Lithium Carbonate / therapeutic use
  • Male
  • Self-Injurious Behavior / psychology

Substances

  • Antimanic Agents
  • Antipsychotic Agents
  • Hypnotics and Sedatives
  • Lithium Carbonate