Abstract Details

Title Electroconvulsive Therapy (ECT) for the Treatment of Refractory Depression in Huntington’s Disease Patients: A Case Series

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-045

Objective In this single site case series, we review electroconvulsive therapy (ECT) use for four Huntington’s Disease (HD) patients with medication-refractory depression to better assess the utility of ECT in this population.

Background HD is a progressive neurodegenerative disease characterized by involuntary movements, cognitive symptoms, and neuropsychiatric decline. Neuropsychiatric symptoms contribute to considerable morbidity as well as mortality in the disease with suicide accounting for 5.7 out of every 100 deaths in HD patients, 4-8 times the rate of the general population. ECT has been used as a treatment for severe or medication-refractory mood disorders and catatonia since the mid-20^th century. However, it is not standard of care for the management of refractory symptoms in HD, and there is a paucity of published literature on ECT use in this population. Some case studies have demonstrated ECT’s positive effect on depression and agitation in HD, but the data is limited.

Design/Methods

We performed a single-center retrospective analysis of ECT cases for refractory mood symptoms in HD at Northwestern Memorial Hospital from 2016-2018, reviewing de-identified patient details, presenting symptoms, ECT course details, and clinical response to ECT.

Results

Four patients underwent inpatient ECT with three patients continuing maintenance therapy as an outpatient. They all had improvements in depression, agitation, and suicidal ideation leading to successful hospital discharge. Two of the four patients also had psychotic symptoms that also improved with ECT. One patient reported subjective improvement in cognitive and motor symptoms.

Conclusions

This case series adds to the small body of case reports on the topic of ECT for HD. Larger scale, prospective studies are warranted to further investigate the specific role and protocol for the use of ECT in HD to establish a more universal, evidence-based approach to the use of ECT in refractory mood symptoms in this population.

Authors/Disclosures
Jennifer Adrissi, MD PRESENTER	Dr. Adrissi has nothing to disclose.
Neil A. Nadkarni, MD (Northwestern University, McGaw Medical Center)	No disclosure on file
	No disclosure on file
Danny Bega, MD (Northwestern University)	Dr. Bega has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GE Healthcare. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as a Consultant for WebMD. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Acorda Therapeutics. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurocrine Biosciences. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus Pharmaceuticals. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion. Dr. Bega has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACTN / ANA. The institution of Dr. Bega has received research support from Huntington Disease Society of America. The institution of Dr. Bega has received research support from Parkinson Foundation.

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