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J ECT. 2013 Sep;29(3):243-6. doi: 10.1097/YCT.0b013e3182809c01.

Electroconvulsive therapy for severe neuropsychiatric lupus with psychosis.

Author information

1
Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore. Lynnette_Tan@ttsh.com.sg

Abstract

OBJECTIVE:

Systemic lupus erythematosus (SLE) is an autoimmune disorder that requires long-term management and can have a profound impact on the quality of life of patients. Among patients with SLE, neuropsychiatric manifestations are fairly common, occurring in up to 75% of patients with SLE. Neuropsychiatric symptoms of SLE (NPSLE) presenting with psychosis, however, is less common, with a prevalence of up to 11%. Treatment of psychosis in NPSLE has largely involved antipsychotics and immunosuppressants, with not much in the literature about the use of electroconvulsive therapy (ECT) as a method of treatment.

METHODS:

We report 3 cases of patients who presented with psychosis during a lupus relapse, who were treated successfully with ECT after their symptoms did not improve on medical treatment.

RESULTS AND CONCLUSION:

Although all 3 patients were treated with antipsychotics and immunosuppressants simultaneously with the ECT sessions, the time scale of these 3 case studies suggests that ECT played a role in the resolution of these patients' symptoms. Our 3 cases highlight that ECT can be safely and effectively used in patients with NPSLE with prominent psychotic symptoms.

PMID:
23535497
DOI:
10.1097/YCT.0b013e3182809c01
[Indexed for MEDLINE]
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