Electroconvulsive Therapy for Depression in a Cardiac Transplant Patient

Abstract

Received August 25, 2000; revised February 13, 2001; accepted February 23, 2001. From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD. Address reprint requests to Dr. Lee, Meyer 248, Department of Psychiatry and Behavioral Science, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287–5371. Email: hochang@jhmi.edu Copyright 2001 The Academy of Psychosomatic Medicine. Lingering limitations in social, occupational, and social functioning may limit a patient’s quality of life after a heart transplant. The survival rate of patients at 1 year and 3 years post—heart transplant are 85% and 75%, respectively. A 1996 epidemiological study of 154 heart transplant recipients (83% men) reported lifetime prevalence rates of major depression at 23.7% and 17.3% preand 12 months posttransplant, respectively. When pharmacotherapy fails, electroconvulsive therapy (ECT) is often a lifesaving treatment option for the treatment of depression. There have been two case reports of the successful use of ECT in patients with major depressive disorder who had cardiac transplant surgery 13 months and 5 years before receiving ECT. The following case report describes the successful use of ECT in a depressed patient who was treated less than 3 months after cardiac transplant surgery. To our knowledge, this is the shortest duration between heart transplant surgery and a successful course of ECT.