RESUMEN
BACKGROUND: It is a well-known fact that prolactin increases after Electroconvulsive Therapy (ECT), but in later studies it was found that the amount of prolactin rise after each ECT gradually declines on successive ECT. Many studies have found that there is a correlation between this prolactin drop and improvement in psychopathology. But the results found were inconsistent and only limited to depression. AIM: To see the serum prolactin changes during a course of ECT in patients suffering from BPAD mania and to assess whether any correlation exists between these changes and improvement in psychopathology. METHORD: 20 inpatients meeting diagnostic criteria for BPAD mania as per ICD-10 who were planned to receive ECT were taken as cases and 20 BPAD mania patients not receiving ECT were taken as controls. Blood for prolactin and psychopathology on YMRS assessed three times in each case. First at baseline, second after 1st ECT and third after last ECT. Similarly controls were assessed at baseline and after three weeks for prolactin and psychopathology. RESULTS: In patients who received ECT, serum prolactin levels were significantly raised after 1st ECT (mean 78.65) compared to baseline (mean 54.02). Prolactin level significantly decreased after a course of ECT (mean 67.22). There was no significant correlation between prolactin changes and in YMRS score. CONCLUSION: There is no significant correlation between prolactin changes during a course of ECT and improvement in psychopathology in BPAD mania patients suggesting the prolactin rise may be an epiphenomenon to ECT rather than reflection of therapeutic process.
RESUMEN
Lithium-induced cardiotoxicity, though rare at therapeutic levels, has been reported frequently in overdoses. We report a patient who developed sinus bradycardia while being treated with lithium carbonate even though the serum lithium levels were within the therapeutic range. It reversed following withdrawal of lithium and did not reappear with subsequent treatment with valproate.