The Treatment of Disruptive Vocalization in Dementia (Behavioral and Psychological Symptoms of Dementia) With Electroconvulsive Therapy

OBJECTIVE: There is emerging evidence that electroconvulsive therapy (ECT) can help with the behavioral and psychological symptoms of dementia. One of the most distressing behavioral symptoms of dementia is disruptive vocalization. Previous small case series have suggested that antidepressants and ECT can be beneficial for this distressing condition. The aim of this study was to describe the successful use of ECT in treating 5 patients with disruptive vocalization. METHODS: A retrospective chart review of 5 patients with dementia of mixed etiologies was conducted comparing pretreatment and posttreatment scores on the Cohen-Mansfield Agitation Inventory. All 5 patients had unsuccessful treatments with nonpharmacological methods and pharmacotherapy including antidepressants. RESULTS: After completion of a series of ECT, the mean verbal agitation score decreased from 6.8 (95% confidence interval, 6.3-7.3) to 2.3 (95% confidence interval, 1.3-3.3), with both clinical and statistical significance (P < 0.001). CONCLUSIONS: Although further research is needed, these findings support considering the use of ECT for disruptive vocalization in dementia.