Electroconvulsive therapy for major depression in an elderly person with epilepsy

The case of a 72-year-old woman with a history of 40 years of epilepsy and medication-refractory severe depression is described. Despite the chronicity of the present depressive episode, mild MRI pathology and somatic complications, especially pneumonia and drug-induced hyponatraemia, we observed rapid and complete remission of depressive symptoms in the course of ECT. Neither cognitive impairment nor a perceptible influence on the neurological illness was seen, and no increase in seizure threshold has been observed during the course of 2 years maintenance ECT treatment. This article is offered in an attempt to enrich the clinical literature in this field and therefore encourage psychiatrists to consider ECT and MECT as a safe and efficacious option in epileptic patients with major depressive disorder.