Use of Electroconvulsive Therapy for Catatonia in Down Syndrome Regression Disorder: A Systematic Review, Case Series, and Analysis.
Seri Lim, Kaidi Kang, Elizabeth Oey and 9 others
PMID 42663881WHAT IT FOUND
People with Down syndrome who had catatonia and lost skills or speech showed lower catatonia severity scores after ECT.
Many also received other treatments at the same time, so ECT alone cannot be credited.
Key findings
01Across 32 BFCRS visits from 18 patients, the mean pre-ECT score was 17.35 and the mean post-ECT score was 4.40.
02The pooled analysis found a statistically significant expected reduction in BFCRS score after ECT.
03For 13 patients, active regimens during ECT included lorazepam, fluoxetine, duloxetine, lithium, aripiprazole, lamotrigine, mirtazapine, memantine, escitalopram, famotidine, dextroamphetamine, diazepam, clobazam, IVIG, or steroids.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 27 people and had no untreated or alternative treatment control group. Many patients received other treatments before or during ECT, so the effect of ECT alone cannot be separated. Patients were selected because they had received ECT and had a catatonia rating, which may overrepresent people who improved enough to continue treatment. Data were collected from medical records and published case reports, not prospectively, and ECT parameters were consistently reported only for the 5 patients from the center. BFCRS ratings were inconsistent, and only 18 patients contributed rating visits for the main analysis. All 5 patients from the center had intellectual disability that made subjective side effects hard to verbalize, so adverse effects may have been under-detected.
The easy way to misread this
Do not conclude that ECT alone caused the lower catatonia scores. For 13 patients, active regimens during ECT included lorazepam, fluoxetine, duloxetine, lithium, aripiprazole, lamotrigine, mirtazapine, memantine, escitalopram, famotidine, dextroamphetamine, diazepam, clobazam, IVIG, or steroids, and the study had no untreated control group.