AUTHOR=Yang Xin , Fang Shuping , Liu Yang , Li Jin , Kuang Weihong 

TITLE=Case Report: Epistaxis with electroconvulsive therapy: a report of 2 patients

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1443630

DOI=10.3389/fpsyt.2025.1443630

ISSN=1664-0640

ABSTRACT=Electroconvulsive therapy (ECT) is an effective treatment for various psychiatric disorders such as depression, bipolar disorder, and schizophrenia but is associated with certain side effects. Epistaxis following ECT appeared to be rare, with few reports in the medical literature. We reported two cases of epistaxis following ECT. In one case, we observed a sudden transient increase in blood pressure during ECT, followed by epistaxis. In the other case, the patient developed epistaxis after ECT, with subsequent ECT sessions leading to increasingly difficult-to-control nosebleeds. Nasal endoscopy revealed vascular engorgement in the Little’s area. Our cases suggested that sudden increases in blood pressure during ECT may trigger epistaxis. Repeated ECT sessions may exacerbate this issue, making epistaxis more challenging to manage. Clinicians must be aware of this potential adverse event and should reevaluate the efficacy and risks of ECT for patients who develop epistaxis.