Current evidence does not show a significant increase in cognitive side effects associated with lithium use during ECT. However, methodological limitations, sensitivity to meta-analytic assumptions and clinical heterogeneity preclude definitive conclusions. Large prospective studies using standardized cognitive assessments are needed to confirm the tolerability of concurrent lithium and ECT use. While our findings support the cautious continuation of lithium during ECT, individualized clinical decision-making remains crucial to maximize efficacy and minimize cognitive burden.
Eynde et al. (Wed,) studied this question.