The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State

Psychiatr Clin North Am. 2020 Mar;43(1):187-197. doi: 10.1016/j.psc.2019.10.010. Epub 2019 Dec 2.


Electroconvulsive therapy (ECT) results effective in two-thirds of the patients with severe and drug-resistant mixed states. The episode duration is the main predictor of nonresponse. This practice may increase the risk of mood destabilization and chronic complications and may decrease the chance of recovery in many patients. Compared with the burden of neurologic and metabolic side effects associated with long-term use of complex pharmacologic regimens, ECT should be considered a safe option with a very low incidence of severe adverse events and a long-term nondestabilizing effect.

Keywords: Bipolar disorder; Electroconvulsive therapy; Mixed states.

Publication types

  • Review

MeSH terms

  • Bipolar Disorder / therapy*
  • Depressive Disorder, Major / therapy*
  • Electroconvulsive Therapy*
  • Humans
  • Treatment Outcome