A patient with mania and photoconvulsive epilepsy

To describe a young patient who had a comorbidity of mania and photoconvulsive epilepsy. This patient presented with a clinical picture of mania which proved difficult to treat until an EEG revealed the presence of photoconvulsive epilepsy. Treatment with haloperidol and lithium was unsuccessful but the addition of carbamazepine produced a dramatic response. Haloperidol was stopped and the patient maintained on lithium and carbamazepine. A successful outcome was achieved with carbamazepine and the patient has remained well on this treatment for 2 years. The authors postulate that there may be an association between photoconvulsive epilepsy and mania, perhaps on a kindling basis. The literature pertaining to the psychiatric aspects of photoconvulsive epilepsy is reviewed.