Donepezil For Post-ECT Delirium: Case Report

Out on PubMed, from clinicians in Delaware, is this case report:

The Role of Acetylcholinesterase Inhibitors in the Treatment of Prolonged Postelectroconvulsive Therapy Delirium.

Gutowski B, Bomasang-Layno E.Case Rep Psychiatry. 2022 May 30;2022:6966882. doi: 10.1155/2022/6966882. eCollection 2022.PMID: 35677728

The abstract is copied below:

Electroconvulsive therapy (ECT) is an extremely effective treatment modality for severe depression but is often associated with transient or persistent cognitive impairment. ECT-induced cognitive impairment, however, can serve as a deterrent to completion of treatment. We present a case of a prolonged post-ECT delirium lasting approximately 3 weeks in which donepezil, an acetylcholinesterase inhibitor, was used and was successful in shortening the duration of post-ECT delirium.

The case report is here.

And from the text:

This case report raises some issues about the diagnosis of post-ECT delirium and its management. That the authors did not consider nonconvulsive status as a possible etiology and did not do an EEG seems an oversight. A contributing role for the donepezil in the resolution of the syndrome is possible, but certainly not conclusive. Finally, one wonders (and this is quite speculative) if the low-dose RUL may have actually contributed to the outcome, if there were a component of nonconvulsive status, and a higher stimulus might have resulted in more complete seizure termination.

A full read of the case is recommended (~ 10 minutes) and comments are most welcome, thanks.