Electroconvulsive therapy during pregnancy

Miller, L.J. (1994) Use of electroconvulsive therapy during pregnancy. Hosp Community Psychiatry 45 444—450. 

Wisner, K.L. and Perel,J.M. (1988) Psychopharmacologic agents and electroconvulsive therapy during pregnancy and the puerperium. In Cohen, R.L., ed. Psychiatric Consultation in Childbirth Settings. New York Plenum, pp. 165-206. 

Walker R, Swartz CM. Electroconvulsive therapy during high-risk pregnancy. Gen Hosp Psychiatry 1994 16 348-353. 

Electroconvulsive therapy (ECT) is used for severe mania or depression during pregnancy and for mixed episodes prior to treatment, anticonvulsants, lithium, and benzodiazepines should be tapered off to maximize therapy and minimize adverse effects. 

Electroconvulsive therapy, an effective treatment for depression during pregnancy (Eorssman, 1955 Impastato et ah, 1964), should be considered when other... 

For patients who experience a breakthrough episode, the medication dose should first be optimized. When first-line medications at optimal dose fail to control symptoms, recommended treatment options include the addition of another first-line medication. Alternative treatment options include adding carbamazepine or oxcarbazepine in lieu of an additional first-line medication, adding an antipsychotic if not already prescribed, or changing from one antipsychotic to another. Of the antipsychotics, clozapine may be particularly effective for treatment of refractory illness. Electroconvulsive therapy (ECT) may also be considered for patients with severe or treatment-resistant illness. In addition, ECT is a potential treatment for patients with mixed episodes or for severe mania experienced during pregnancy. 

---