Maintenance ECT for the treatment and resolution of agitation in Alzheimer’s dementia

L’ECT di mantenimento nel trattamento e risoluzione dell’agitazione nella demenza di Alzheimer

G. Fàzzari (1), C. Marangoni (2), O. Benzoni (1)

1 UO Psichiatria 23, Azienda Ospedaliera Universitaria Spedali Civili di Brescia, Montichiari Hospital; 2 Dipartimento di Scienze Biomediche e Chirurgico Specialistiche, Università di Ferrara

Summary

Background

Behavioural and psychological symptoms of dementia (BPSD) refer to the distressing, non-cognitive symptoms of dementia and include agitation or restlessness; wandering and non-specific behaviour disturbance e.g. hoarding; verbal or physical aggression; anxiety; depression; psychosis, delusions, hallucinations; repetitive vocalisation, cursing, screaming and swearing; sleep disturbance; shadowing; sundowning.

Clinical case

We report the case of a patient with advanced stage Alzheimer’s dementia with severe BPSD not respondent to several trials of antipsychotis, anxiolytics and mood stabilizers. The patient was treated with acute and maintenance bilateral ECT.

Conclusions

This case represents a successful use of acute and maintenance ECT in the treatment of BPSD, in particular psychomotor agitation, associated with Alzheimer’s dementia. According to our experience, it is important to manage this psychiatric manifestations with ECT, especially in those cases in which the psychopharmacological treatment alone does not give satisfactory results in clinical improvement.

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