This short editorial by two psychiatrists answered two, unrelated questions in my head the last week or so. First, a movement disorder specialist recently asserted that all DLB patients eventually develop parkinsonism. This editorial points to research that "50% of [DLB] patients have extrapyramidal motor symptoms at diagnosis while 75% develop them during the course of the illness."

Second, in the presentation by the Whitworths yesterday to our local LBD support group members, I noted that depression can often appear in DLB before the onset of dementia. Helen Whitworth asked me what percentage of those with DLB have depression. I didn't know except to say that it's a common symptom. This editorial points to research that "prevalence estimates of depression associated with DLB [range] from 20% to 65%."

This editorial encourages the medical community to consider using electroconvulsive therapy (ECT) in the treatment of several DLB symptoms -- depression, psychosis (hallucinations and delusions), and motor symptoms. The editorial points out that ECT doesn't have the side effects that medication has -- antipsychotics, antiparkinsonism medication, or tricyclic antidepressants (which are anticholinergic). The side effects of ECT are not detailed in this editorial.

The authors say that "the stigma associated with ECT may be one reason why this efficacious treatment option is neglected [in DLB]." A second reason is that neurologists "are generally not well versed in ECT and psychiatrists tend to overlook ECT when it comes to patients with co-morbid neurological conditions."

I've copied the citation below.

Robin



Editorial
Electroconvulsive therapy (ECT) for dementia with Lewy bodies

F. Tuna Burguta and Charles H. Kellnera
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY

Medical Hypotheses. 2010 Jun 8. [Epub ahead of print]

Electroconvulsive therapy (ECT)

It just sounds scary like you see in all the movies.

This post encourages me to do some research to find out what an ECT is really like. My initial thought if a doctor suggested it to me would be "NO WAY" because I would be thinking of Electric shock without really knowing what I was talking about.

My grandfather had several ECT treatments for depression after my grandmother died. Other than some temporary short-term memory loss, he was fine and his depression was greatly improved. It's certainly safer than many medications. Something small that can be popped into the mouth and swallowed seems so harmless, doesn't it?

Interesting to see. About twenty years ago in Seattle I worked with a young psychiatrist who was a pioneer in the 'new' ECT [safe, non-traumatic, non-scary]. Although I was not involved in this procedure, I read some of his research papers and they tended to dispel any 'torture chamber' vision of ECT.
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On edit: It was actually 25 years ago! Wow, how time flies!