Cumulative electroconvulsive therapy sessions and focal epilepsy: A nationwide cohort study in Japan.
Focal epilepsy diagnosed in up to 9.1% of patients with 80-89 cumulative electroconvulsive therapy sessions.
Cumulative electroconvulsive therapy sessions and focal epilepsy: A nationwide cohort study in Japan.
Electroconvulsive therapy (electroconvulsive therapy) is widely used for severe psychiatric disorders, yet concerns remain regarding possible epileptogenic effects associated with prolonged or repeated exposure.
We conducted a retrospective cohort study using a nationwide claims database including 3733 patients who received electroconvulsive therapy between 2008 and 2025.
Nearly 1 in 11 patients receiving 80-89 electroconvulsive therapy sessions were later diagnosed with focal epilepsy.
Among 3733 patients (mean age 56.9 years; 66.4% female), 96 (2.6%) developed focal epilepsy, corresponding to an incidence of 3748 per 100 000 person-years.
Each additional electroconvulsive therapy session was associated with higher odds of focal epilepsy (β = 0.0099, p = 0.004).
In exploratory time-varying analysis, reaching ≥ 50 sessions was associated with increased hazard, although event numbers were limited.
Following epilepsy diagnosis, 70.8% discontinued electroconvulsive therapy and 98.0% received antiseizure medication.
Electroconvulsive therapy (electroconvulsive therapy) is an effective treatment for severe mental illnesses. However, its long-term neurological effects are not fully understood.
We analyzed nationwide data from 3733 patients in Japan who received electroconvulsive therapy and examined whether repeated treatments were associated with new diagnoses of focal epilepsy.
Ninety-six patients (2.6%) were diagnosed with focal epilepsy after starting electroconvulsive therapy.