Using electroconvulsive therapy for patients with neurological disease.

In the United States electroconvulsive therapy (ECT) is not commonly used with patients who have conditions affecting the structure or function of the brain. Many clinicians may be unaware, therefore, that ECT has been used safely to treat patients with combined major depression and central nervous system disorders; patients with organic mental syndromes, particularly delirium; and patients who have psychiatric disorders that mimic or are distorted by brain disease. The author discusses the successful use of ECT with such patients as well as potential dangers of the treatment through a review of worldwide experience with ECT and presentation of case examples. He concludes by suggesting possible mechanisms through which ECT may benefit both depression and organic mental syndromes.