Electroconvulsive therapy in children and adolescents

Abstract

Electroconvulsive therapy (ECT) is a recognized and effective treatment in adults for several psychiatric and neurological conditions in which the use of pharmacotherapy is ineffective, untimely or contraindicated. It has been used with success in mood and psychotic disorders, catatonia, neuroleptic malignant syndrome, Parkinson’s disease and intractable seizures. Its benefits have been recognized and its risks identified through an extensive body of research. The benefits of ECT are not limited to the adult population; research has been conducted on its use in child and adolescent populations for decades. In 2004, the American Academy of Child and Adolescent Psychiatry published practice parameters for the use of ECT in adolescent populations. However, ECT continues to be underused in cases where it is clearly indicated. In this article, we review the use of ECT in the adolescent population; its indications, administration, contraindications and risks, with emphasis on articles published after the American Academy of Child and Adolescent Psychiatry practice parameters were formulated. We also review reasons behind the underutilization of ECT in adolescents for whom this treatment modality is indicated.

Keywords::

• adolescents
• adverse effects
• children
• ECT
• electroconvulsive therapy
• methods
• therapeutic use

Financial & competing interests disclosure

Hesham Hamoda was supported by a Dupont-Warren Fellowship from the Harvard Medical School Department of Psychiatry. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.