ECT therapy may cut suicide risk in bipolar patients

In a major study on patients with untreatable bipolar disorder, the researchers have shown that ECT (Electroconvulsive Therapy) was able to reduce suicide risk by 84 per cent in high-risk patients, as well as giving effective treatment to around 72 per cent of sufferers.

ECT is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments.

ECT involves a brief electrical stimulation of the brain while the patient is under anaesthesia

Bipolar disorder, where patients exhibit emotional instability and may experience very severe mood swings, is amongst the most common mental health disorders.

Bipolar disorder can cause mixed states of mania and depression; this mix can lead to an increased risk of suicide.

Most patients can control the condition via prescription drugs, but almost a third of patients are resistant to treatment.

The study, published in the World Journal of Biological Psychiatry, followed bipolar patients and treatment from a single centre and confirmed that ECT can reduce suicide risk, and allow a majority of patients to return to a more normal life.

"ECT was invented in Italy, but despite this there are very few clinics in Italy which offer the treatment nowadays," said study author Giulio Emilio Brancati from the University of Pisa UP in Italy.

"A lot of patients who have failed with other treatments are referred to the Pisa clinic, which is why we were able to gather so much data from a single clinic," Brancati added.

For the study, between January 2006 and July 2019, 670 patients were referred to the Pisa psychiatry clinic for ECT treatment for bipolar disorder.

The treatment showed great success in treating bipolar sufferers, with remission rates of over 60 per cent for symptoms characteristic of bipolar "mixed states", such as emotional overreactivity, motor hyperactivity, aggressiveness and others.

Most importantly, 77 of the patients were classified as being at severe risk of suicide.

After treatment only two remained at severe risk, while 65 showed no risk at all.

"This is an 84 per cent drop in suicidality after ECT treatment. We have not found this level of acute improvement with any other treatment", said Brancati.

"This study again shows that ECT can be a life-saving treatment and should not be withheld to patients suffering from difficult to treat mood disorders such as bipolar disorder," said study author Henricus Ruhe.