Efficacy and Safety of Electroconvulsive Therapy for Dementia With Lewy Bodies, Its Prodromal Phase, and Parkinson's Disease Dementia: Eight Cases Encountered at Our Institution

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ABSTRACT Purpose This study aimed to assess the efficacy and safety of electroconvulsive therapy (ECT) for treating psychiatric symptoms and parkinsonism in patients affected by dementia with Lewy bodies (DLB), its prodromal phase, and Parkinson's disease dementia (PDD). Methods We retrospectively reviewed eight patients (four males, four females; mean age 71.5 ± 8.9 years) diagnosed with probable DLB or its prodromal phase, based on diagnostic criteria, who underwent ECT between January 2020 and December 2025. The efficacy and safety of ECT for psychiatric symptoms was evaluated using the Brief Psychiatric Rating Scale (BPRS) before and after treatment, and parkinsonism was assessed based on pre‐ and post‐Hoehn‐Yahr (HY) stage. Changes in scores were statistically analysed using the Wilcoxon signed‐rank test. Adverse effects occurring during and after ECT were also recorded. Results Three patients underwent ECT using the dose‐titration method, while the others were treated using the half‐age method. One patient experienced recurrent delirium following ECT, while no complications were noted in the other patients. There was a significant improvement in BPRS score observed (Wilcoxon signed‐rank test, p = 0.012), though no significant change was noted in HY stage ( p = 0.197). Conclusion These results suggest that ECT is a safe, well‐tolerated, and effective treatment for patients with psychiatric‐onset prodromal DLB, or mild DLB who present pharmacotherapy‐resistant psychiatric symptoms. ECT may be a viable therapeutic option for DLB, particularly in an early stage of dementia.