Electroconvulsive therapy for treatment of depressive episode in the course of bipolar affective disorder in a patient with cannabis addiction and coexisting neurological comorbidities - a case study

This article presents a comprehensive case study of a 37-year-old male patient who was admitted to a psychiatric clinic for the treatment of bipolar affective disorder, characterized by a manic episode with psychotic symptoms, concurrent THC addiction, and post-traumatic neurological disorder. Despite extensive pharmacological treatment and psychotherapy spanning several months, it was the administration of Electroconvulsive Therapy (ECT) that ultimately facilitated a noteworthy remission. This intervention resulted in a marked improvement in the patient's mood and a regression of symptoms, allowing for a brief follow-up in an outpatient setting, which the patient discontinued after three visits. Remarkably, the patient remained symptom-free for three years post-discharge, without the use of any medication, until he presented with hypomania symptoms. This case underscores the pivotal role of ECT in the treatment of bipolar affective disorder, particularly in instances where patients exhibit resistance to pharmacotherapy. The aim of the article is to emphasize the importance of ECT as equal in relation to pharmacotherapy. Despite the occurrence of negative associations with this method and anxiety among patients and medical staff, the case indicates a positive ECT influence of treatment, especially in drug-resistant patients.