ECT in a Young Adult With Down Syndrome Regression Disorder

 Out on PubMed, from clinicians in Texas, in JECT, is this case report;

Clinical Response to Electroconvulsive Therapy in a Young Adult With Down Syndrome Regression Disorder.

Kelley BJ, Bailey KJ, Hubregsen JJ.J ECT. 2024 Dec 3. doi: 10.1097/YCT.0000000000001093. Online ahead of print.PMID: 39652068

The abstract is copied below:

Down syndrome regression disorder (DSRD) is a condition in which individuals with Down syndrome experience a decline in social and adaptive functioning in adolescence to early adulthood. Initially described as catatonic psychosis and later designated Down syndrome disintegrative disorder (DSDD), the etiology for DSRD remains unclear but has been hypothesized to relate to autoimmune function, stress, and psychiatric disease. DSRD presents heterogeneously and has no clearly established diagnostic criteria, which can complicate treatment recommendations. ECT has been used to successfully treat DSRD, but the number of reported cases remains low, especially when it is unclear whether there are comorbid catatonic features. Here, we present a case of successful use of ECT in an individual with DSRD in which catatonic features were difficult to ascertain, and we make recommendations for the use of ECT in the treatment of DSRD.

The case report is here.

And here:

After reading this case report, I came up with a criterion for an excellent case report: the "discussion" answers almost all the questions the reader has thought of, while reading the clinical presentation. This fits the bill.

The extremely long course before successful ECT was administered was noteworthy. 

One additional question I would pose: when will we begin to consider ECT as a potential primary treatment for some of these patients, rather than giving such primacy to immunotherapies?

Kudos to these authors at UT Southwestern.