Electroconvulsive Therapy for Refractory Anxiety and Depression in Superficial Siderosis: A Case Report.

OBJECTIVES

To report the first documented case of anxiety and depression related to superficial siderosis that responded to electroconvulsive therapy (ECT).

METHODS

A 58-year-old man with traumatic superficial siderosis presented with panic attacks and major depressive disorder unresponsive to multiple pharmacologic trials. Brain MRI revealed hemosiderin deposition in cerebellar-limbic structures. A course of bifrontal brief-pulse ECT (8 sessions) was administered.

RESULTS

After 8 sessions, the patient experienced full remission of panic attacks and functional recovery. The PHQ-9 score decreased from 21 to 7, and the GAD-7 score decreased from 19 to 6, with sustained improvement at the six-week follow-up.

CONCLUSIONS

This case suggests that ECT can safely and effectively target cerebellar-limbic circuit dysfunction in superficial siderosis and supports further investigation into neuromodulation for refractory psychiatric symptoms in this population.