Parkinsonism: improvement by electroconvulsive therapy.

Not infrequently, patients with parkinsonism either do not respond to antiparkinsonian medications or cannot tolerate those medications because of side effects. We report a patient who, having responded poorly to every medical regimen for parkinsonism, showed marked improvement in gait and balance after electroconvulsive therapy (ECT) for treatment of concomitant severe depression. ECT has been found to increase the sensitivity of postsynaptic dopaminergic receptors and noradrenergic receptors and to facilitate, for a considerable period of time, the neurotransmission along dopaminergic and noradrenergic pathways in the brain. Thus, ECT may represent another important therapeutic modality for patients with parkinsonism.