Hot Topics in Neuroscience: Is Electroconvulsive Therapy a Treatment for Depression Following Traumatic Brain Injury?

| April 1, 2018 | 0 Comments

This ongoing column explores off-label or emerging treatment options, drug development trends, and theoretical concepts in the field of neuroscience.

by Anja Srienc, PhD, MD; Puneet Narang, MD; Simrat Sarai, MD; Yee Xiong, MD; and Steven Lippmann, MD

Dr. Srienc is with the Medical Scientist Training Program & Graduate Program in Neuroscience at the University of Minnesota in Minneapolis-St. Paul, Minnesota. Dr. Narang is Assistant Professor at the University of Minnesota, and Staff Physician, Lead ECT Psychiatrist at the Regions Hospital in Minneapolis-St. Paul, Minnesota. Dr. Sarai is Research Scholar at the University of Louisville School of Medicine in Louisville, Kentucky. Dr. Xiong is Psychiatry Resident, HCMC-Regions Psychiatry Residency Program in Minneapolis, Minnesota. Dr. Lippmann is Professor of Psychiatry at the University of Louisville School of Medicine in Louisville, Kentucky.

Innov Clin Neurosci. 2018;15(13–4):43–46

Funding: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosures: The authors have no conflicts of interest relevant to the content of this article.

Abstract: Traumatic brain injury (TBI) can be caused by blunt or penetrating injury to the head. The pathophysiological evolution of TBI involves complex biochemical and genetic changes. Common sequelae of TBI include seizures and psychiatric disorders, particularly depression. In considering pharmacologic interventions for treating post-TBI depression, it is important to remember that TBI patients have a higher risk of seizures; therefore, the benefits of prescribing medications that lower the seizure threshold need to be weighed against the risk of seizures. When post-TBI depression is refractory to pharmacotherapy, electroconvulsive therapy (ECT) could provide an alternative therapeutic strategy. Data remain sparse on using ECT in this seizure-prone population, but three case reports demonstrated good outcomes. Currently, not enough evidence exists to provide clinical recommendations for using ECT for treating post-TBI depression, and more research is needed to generate guidelines on how best to treat depression in TBI patients. However, the preliminary data on using ECT in patients with TBI are promising. If proven safe, ECT could be a powerful tool to treat post-TBI depression.

Keywords: Traumatic brain injury, TBI, mood disorders, depression, treatments, electroconvulsive therapy, ECT

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Category: Hot Topics in Neuroscience, Past Articles

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