There were two new ECT articles published yesterday (Feb. 4) on PubMed: The Role of Electroconvulsive Therapy in the Treatment of Severe Bipolar Mixed State Perugi G, et al. Psychiatr Clin North Am 2020 - Review . PMID 32008684 Anesthesia for Electroconvulsive Therapy Chawla N. Anesthesiol Clin 2020 - Review . PMID 32008651 The first, Perugi et al., is an important addition to the literature. It provides a comprehensive review of the data about the utility of ECT for the treatment of severe bipolar disorder, in this case, for mixed episodes. They make several key points: -mixed states are difficult to diagnose -longer episode duration predicts poorer response, so leaving ECT as a "last resort" treatment option is problematic -there is a low incidence of serious adverse effects -ECT is a mood stabilizing treatment There has long been a reluctance to recognize ECT as a crucial treatment for severe bipolar disorder. This group of Italian
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