Use of ultra-brief pulse electroconvulsive therapy to treat severe postnatal mood disorder

Abstract

Objective: To describe the use of ultra-brief electroconvulsive therapy (ECT) in three postnatal women with severe, treatment resistant depression. The indications and evidence for the use of ECT in the treatment of postnatal depression are discussed. Method: We present a case series and review relevant literature. Results: Three patients with severe episodes of depression postnatally, not responding to medication, presented to a private mother-baby inpatient unit. All three patients had significant suicidal ideation and two underwent involuntary treatment in public hospitals during the course of their presenting illnesses. They were treated with right unilateral ultra-brief ECT and a range of medications. All women began to respond within 3–6 treatments and no significant cognitive side effects were observed. Conclusions: Our findings suggest that right unilateral ultra-brief ECT is a useful treatment modality for severe and treatment resistant depression in the postnatal period. ECT is a useful option in women who have experienced significant medication side effects, or for those whose severity of illness necessitates rapid symptom resolution. Ultra-brief ECT caused minimal clinically observable side effects, which may assist mothers to resume care of their infants more rapidly.