No. I have not come across any case in my career who had manifested with Mania following ECT.

Well I have a pateint who was treated on ECT for psychosis , because he has two previous episodes of neuroleptic malignant syndrome on antipsychotics ! He developed manic symptoms after 5th ECT course was administered and has been on mood stabiliser since . Just wondering the prospectus of using ECT again ?

http://www.ncbi.nlm.nih.gov/pubmed/11940945?dopt=Abstract&holding=f1000,f1000m,isrctn

Http://www.jmedicalcasereports.com/content/3/1/94

In my experience some depressed patients may experience mild hypomania during ECT. However, this is no real clinical problem, since ECT is effective for mania as well.

Therefore, my advice is to continue ECT, it is very likely that the hypomania will resolve.

Thanks Sergey , it's helpful .

It is very rare that we in our practice exceed more than 6 ECt's for a patient and that too we resort to ECT's only twice a week.Side effects are less .Concurrent with judicious use of psychotropic drugs we have seen excellent improvement in our patients ,hence use of ECT in my view should continue in acute conditions that warrant use of ECT.

Prof D Saldanha

We had an interesting case of a treatment resistant depression who was advised ECT ,he started improving as early as 2nd sitting and was in full blown mania on 2nd day after third sitting .ECT was stopped and he was put on standard treatment after 2months he continued in hospital on three mood stabilizers with highly disruptive symptoms .ECT treatment was restarted and he improved after 6th sitting and continues to be symptom till date

Usually not, but there are cases where mania has been switched. Generally it is safe that it is a treatment of choice for manic pregnant females.

I perform ECT for almost 25 years, but I have never seen a switch to full blown mania.

Patients may switch to mild hypomania, but since ECT is also very effective in (hypo)mania, the best option is to continue ECT until the patient is in remission.

Hi,

I came across this question by chance. I thought it might be useful to add that there are actually reports of ECT-induced mania or hypomania (probably commoner). 

Hope the following publications are helpful.

Best regards,

Qin Xiang

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-3-94

Article ECT-Induced and Drug-Induced Hypomania

Article ECT-induced mania

I agree with Tom's observations here. I have had a patient switch to hypomania but the continued administration of ECT settled the switch. Though, after this, we treated him as having Bipolar Disorder.

Vikas Menon Essentially because ECT is an anti-depressant, anti-manic, anti-psychotic, anti-NMS, anti-suicidal and anti-catatonic, it sounds like an omnipotent treatment in severe mental illnesses... As Tom Birkenhager rightly said, it is beneficial to continue the course of ECT until the patient remits when switch to hypomania/mania noted. I am curious to look at the 'numbers' of psychotropic-induced switch vis-a-vis ECT-induced switch. Any paper that has examined this critically?

@Vikas Menon: I think you pointed out an important aspect in your comment: If hypomanic phase appears is it a sign of possible bipolarity or "only" an adverse effect of the therapy?

Some researchers/physicians call it bipolar II or III - whatever I agree that it's also important to ask in this situation if the patient considered as unipolar depressed can suffer from a bipolar disorder. I saw one patient who showed short term euphoria as she got very fast much better during a course of ECT, however in the context of feeling relieved that she has a life quality again it's seemed to be more a physiological reaction and didn't last more days.