Electroconvulsive therapy for neuropsychiatric symptoms in a patient with posterior cortical atrophy associated with Alzheimer's disease and a history of depression: A case report and review of the literature

Posterior cortical atrophy (PCA) is a common type of early-onset Alzheimer's disease (AD). The most common neuropsychiatric symptoms (NPS) in PCA are depression, anxiety, apathy, and irritability. Our patient had a history of depression and was diagnosed with PCA at the age of 58 years. Three years after the diagnosis, the patient's cognitive functions rapidly declined, and she was referred to our psychogeriatric service due to significant agitation and ongoing extrapyramidal side effects. During the hospitalization, the old-age psychiatrist observed depressive symptoms and severe behavioral disturbances (especially aggressiveness and irritability) that were resistant to pharmacological treatment. The old-age psychiatrist initiated electroconvulsive therapy (ECT) treatment, which resulted in a reduction of both NPS and the prescription of psychotropic drugs. ECT was effective and safe in the treatment of depression and other NPS in this case of PCA. However, further research is needed to determine the most effective stimulation parameters and the efficacy of ECT stratified according to the different etiopathologies of dementia.