Electroconvulsive therapy for affective disorders in persons with mental retardation.

Despite the efficacy of electroconvulsive therapy for the treatment of affective disorders there are no systematic studies of its effectiveness or safety in the mentally retarded population. A literature search revealed 16 case reports that suggests that it is both as effective and safe with mentally retarded persons as in the general population. Four additional clinical vignettes, with extensive follow-up observation from four to eleven years, are presented in an effort to enrich the literature on this subject. They include patients with rapid cycling bipolar disorder, bipolar disorder, manic phase, major depression with psychotic features and schizoaffective disorder. Issues of diagnostic difficulty and pharmacologic prophylaxis are addressed.