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This version was published on November 1, 2006
Journal of Psychopharmacology, Vol. 20, No. 6, 860-862 (2006)
DOI: 10.1177/0269881106067243

Electroconvulsive therapy in the treatment of depression in a former ecstasy user

Roland W. Freudenmann

Carlos Schönfeldt-Lecuona

Manfred Spitzer

Department of Psychiatry, University of Ulm, Ulm, Germany

Leopold Hermle

Department of Psychiatry, Christophsbad, Göppingen, Germany

Georg Grön

Department of Psychiatry, University of Ulm, Ulm, Germany

Depression in former ecstasy users may not respond to selective serotonin reuptake inhibitors (SSRIs) possibly due to damaged serotonergic synapses following long-term heavy ecstasy use. We report findings in a patient suffering from MDMA-induced depression which was refractory to several antidepressive medications including selective noradrenergic reuptake inhibitor (SNRI) and SSRI. An add-on repeated bilateral electroconvulsive therapy (ECT) was able to achieve a stable remission of affective and cognitive symptoms with a follow-up of more than 1.5 years. Add-on ECT could be a treatment option in former ecstasy users with severe depressive disorders that fail to respond to SSRI and/or SNRI. Clinical trials are needed to evaluate further the usefulness of ECT in this patient group.

Key Words: MDMA • ecstasy • depression • 5-HT • neurotoxicity • electroconvulsive therapy


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