Electroconvulsive therapy in a patient with an implanted sacral neurostimulator: a case report on safe administration and short-term outcomes

We present a case of a 35-year-old patient with treatment-resistant depression and an implanted sacral neurostimulator for overactive bladder (OAB). The patient experienced an exacerbation of depression with suicidal ideation and failed multiple medication trials. Due to her significant history of adverse medication reactions and the severity of her condition, electroconvulsive therapy (ECT) was selected as a treatment option despite concerns about the safety of administering ECT with a sacral neurostimulator. To minimize potential risks, the device was placed in Magnetic Resonance Imaging (MRI) mode during each ECT session, successfully avoiding electrical interference. She underwent three ECT sessions, which resulted in significant improvement in depressive symptoms and resolution of suicidal ideation without adverse effects on the device's integrity or OAB symptoms. This case highlights the feasibility and safety of ECT in patients with implanted sacral neurostimulators, emphasizing the importance of precautionary measures and individualized patient assessment. Further research is needed to explore the long-term effects of ECT on such devices and their impact on OAB.