Electroconvulsive therapy in the treatment of depression in a former ecstasy user
Roland W. Freudenmann, Carlos Schönfeldt-lecuona, Manfred Spitzer, Leopold Hermle, Georg Grön
Journal of Psychopharmacology November 1, 2006 DOI: 10.1177/0269881106067243
Summary
Depression in people who formerly used ecstasy heavily may not improve with standard antidepressants like SSRIs, possibly because long-term ecstasy use damages serotonin pathways. A patient with MDMA-induced depression who did not respond to several antidepressants, including an SNRI and an SSRI, achieved stable remission of mood and cognitive symptoms after receiving repeated bilateral electroconvulsive therapy (ECT), with improvement lasting over 1.5 years. Add-on ECT could be a treatment option for former ecstasy users with severe depression that does not respond to antidepressants, though clinical trials are needed to confirm its usefulness.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A patient with MDMA-induced depression refractory to antidepressants |
| Citations | 4 |
| Key finding | Add-on electroconvulsive therapy achieved stable remission of affective and cognitive symptoms in a former ecstasy user with treatment-resistant depression. |
Abstract
Depression in former ecstasy users may not respond to selective serotonin reuptake inhibitors (SSRIs) possibly due to damaged serotonergic synapses following long-term heavy ecstasy use. We report findings in a patient suffering from MDMA-induced depression which was refractory to several antidepressive medications including selective noradrenergic reuptake inhibitor (SNRI) and SSRI. An add-on repeated bilateral electroconvulsive therapy (ECT) was able to achieve a stable remission of affective and cognitive symptoms with a follow-up of more than 1.5 years. Add-on ECT could be a treatment option in former ecstasy users with severe depressive disorders that fail to respond to SSRI and/or SNRI. Clinical trials are needed to evaluate further the usefulness of ECT in this patient group.