ECT plus Antidepressants: a Review

Out on PubMed today are these 2 review articles from the Child and Adolescent Psychiatric Clinics of
North America. Authors include noted child psychiatrists Lee Wachtel and Neera Ghaziuddin from Johns Hopkins University and the University of Michigan, respectively:
Use of Electroconvulsive Therapy in Autism.

Park SE, Grados M, Wachtel L, Kaji S.Child Adolesc Psychiatr Clin N Am. 2020 Jul;29(3):455-465. doi: 10.1016/j.chc.2020.03.003. Epub 2020 May 5.PMID: 32471595
From the abstract:
ECT is a treatment that can safely and rapidly resolve catatonia in autism and should be considered promptly. The literature available for ECT use in youth with autism is consistently growing. Under-recognition of the catatonic syndrome and delayed diagnosis and implementation of the anticatatonic treatment paradigms, including ECT, as well as stigma and lack of knowledge of ECT remain clinical stumbling blocks.

Catatonia in Patients with Autism Spectrum Disorder.

Ghaziuddin N, Andersen L, Ghaziuddin M.Child Adolesc Psychiatr Clin N Am. 2020 Jul;29(3):443-454. doi: 10.1016/j.chc.2020.03.001.PMID: 32471594 
From the abstract:
 Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications.
The recognition that ECT is helpful for children and young adults with autism complicated
by catatonia is one of the most compelling recent advances in ECT. Severe self-injurious behavior (SIB), conceptualized as a form of excited catatonia, is a specific indication that responds well to ECT and maintenance ECT.
I also recommend the below book by Amy Lutz:

Each Day I Like It Better: Autism, ECT, and the Treatment of Our Most Impaired Children

https://www.amazon.com/Each-Day-Like-Better-Treatment/dp/0826519768

As we saw from yesterday's epidemiological article from Lucarelli and colleagues, less than 1% of ECT in the USA is administered to patients 18 years old or younger. It is very likely that more children and adolescents with severe psychiatric illnesses, including catatonia in autism, could benefit from the appropriate prescription of ECT.