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Electroconvulsive Therapy for Elderly Patients With Multiple System Atrophy

A Case Series

Received January 11, 1999; revised March 12, 1999; accepted May 7, 1999. From Beth Israel Medical Center, Department of Psychiatry, 16th Street and First Avenue, New York, NY 10003. Address correspondence to Dr. Roane.

Multiple system atrophy (MSA) is a progressive neurological illness associated with parkinsonism. Electroconvulsive therapy (ECT) improves motor function in Parkinson's disease and, thus, might be beneficial in MSA. Three cases of MSA treated with ECT are described. All patients improved neurologically, but none regained independent ambulation. A review, including previously reported cases, demonstrates that ECT can be safe and effective for depression associated with MSA. Reduced tremor and rigidity may occur, but substantial gait improvement cannot be expected.

Key Words: Parkinson's Disease • ECT • Depression