Management of catatonia in Parkinson’s disease with comorbid bipolar disorder: A case report and review of literature

Table 4 Electroconvulsive therapy in Parkinson’s disease: Reviews and meta-analysis

Acute ECT
Ref.	Study type	Key findings
Faber and Trimble[53], 1991	Narrative review of 27 studies, mostly case reports and uncontrolled studies with small samples; only one randomised-controlled trial; 20 studies included patients with comorbid depression	Approximately 50% of patients receiving ECT, irrespective of the presence or absence of psychiatric comorbidity, showed improvement in parkinsonian symptoms
Kennedy et al[54], 2003	Systematic review of 51 studies evaluating ECT in movement disorder	Significant improvement in both psychiatric and motor symptoms of Parkinson’s disease with ECT; however, significant side effects, particularly delirium (44%-85%), were reported
Borisovskaya et al[55], 2016	Systematic review of 43 studies of ECT in Parkinson’s disease with comorbid depression	Depression improved in 93% of patients; motor symptoms improved in 83%; up to 56% developed delirium, but no long-term cognitive impairment was observed in 94% of patients
Takamiya et al[56], 2021	Meta-analysis of 14 studies (including 1 randomised-controlled trial1) evaluating ECT in PD	ECT significantly improved motor manifestations of Parkinson’s disease; improvement was significant in patients without psychiatric symptoms; ECT also significantly improved depression and psychosis, relieved the wearing-off phenomenon, and did not worsen cognitive functioning
Maintenance ECT
Kramer et al[57], 1999	Major depressive disorder (n = 24)	Major depressive disorder with PD (n = 10)
	Much improved 75%	Much improved 50%
	Partially improved 12.5%	Partially improved 40%

¹The only randomised-controlled trial of active vs sham electroconvulsive therapy was conducted by Andersen et al[58]. In 11 patients with Parkinson’s disease, electroconvulsive therapy improved motor symptoms and the wearing-off phenomenon, but the effects were short-lasting.

PD: Parkinson’s disease; ECT: Electroconvulsive therapy.