MedWorm: Electroconvulsive Therapy

Antiparkinsonian Mechanism of Electroconvulsive Therapy in MPTP-Lesioned Non-Human Primates

Karger Publishers — Wed, 08 Feb 2012 12:48:07 +0100

Neurodegenerative Dis (DOI:10.1159/000334497) (Source: Karger Publishers)

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Treatment-resistant and insufficiently treated depression and all-cause mortality following myocardial infarction [PAPERS]

The British Journal of Psychiatry — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions All-cause mortality following an acute myocardial infarction is greatest in patients with depression who are insufficiently treated and is a risk in patients with treatment-resistant depression. However, the risk of mortality associated with treatment-resistant depression is partly explained by comorbid disorders. Further studies are warranted to determine whether changes in depression independently predict all-cause mortality. (Source: The British Journal of Psychiatry)

Use of ECT in patients with an intellectual disability: review [Special articles]

Psychiatric Bulletin — Wed, 01 Feb 2012 05:00:00 +0100

Aims and method The literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is scarce, despite a higher prevalence of psychiatric disorders than in the general adult population. We carried out a review of articles published before March 2010. All age ranges, severity of disability and diagnoses were included. Results We found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Most patients (79%) showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Many patients relapsed following ECT (32%) and the majority were maintained with medication at follow-up (71%). Clinical implications Electroconvulsive therapy is a valuable treatment ...

Relationship between body mass index and blood pressure elevation during electroconvulsive therapy

Journal of Clinical Anesthesia — Sun, 29 Jan 2012 12:15:49 +0100

Conclusion: BMI correlates with BP elevation during ECT. (Source: Journal of Clinical Anesthesia)

[Confused woman shortly after childbirth].

Tidsskrift for den Norske Laegeforening — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Brauer H, Martinsen EW Abstract Shortly after the birth of her first child a young woman became confused and agitated and was finally involuntarily admitted to an acute psychiatric ward. In spite of appropriate treatment with narcoleptics, she deteriorated from day to day and the staff members were uncertain what to do. New information from her close family concerning previous depressive and hippomanic episodes pointed to probable bipolar disorder. The treatment of choice was electroconvulsive therapy (ECT). In Norway this treatment requires informed consent, which she was not able to give. After consideration and discussions she was finally given ECT as emergency treatment. This had an immediate effect, and after a few treatments she recovered. She was given lithium to pr...

Repetitive transcranial magnetic stimulation in psychiatry

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Biswa Ranjan Mishra, Sukanto Sarkar, Samir Kumar Praharaj, Varun S Mehta, Shreyansh Diwedi, S Haque NizamieAnnals of Indian Academy of Neurology 2011 14(4):245-251Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and relatively painless tool that has been used to study various cognitive functions as well as to understand the brain-behavior relationship in normal individuals as well as in those with various neuropsychiatric disorders. It has also been used as a therapeutic tool in various neuropsychiatric disorders because of its ability to specifically modulate distinct brain areas. Studies have shown that repeated stimulation at low frequency produces long-lasting inhibition, which is called as long-term depression, whereas repeated high-frequency stimulation can produ...

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Electroconvulsive Therapy

About.com Bipolar Disorder — Mon, 16 Jan 2012 05:00:00 +0100

Electroconvulsive therapy or ECT is a treatment in which a convulsion is produced by passing an electric current through the brain. More ... (Source: About.com Bipolar Disorder)

Response rate of catatonia to electroconvulsive therapy and its clinical correlates

European Archives of Psychiatry and Clinical Neuroscience — Fri, 30 Dec 2011 07:08:56 +0100

Abstract Electroconvulsive therapy (ECT) is an important treatment for catatonia. We aimed to study the response rate of catatonia treated with ECT and its clinical correlates in a large sample of inpatients. The ECT parameters of all patients (n = 63) admitted with catatonia between the months of January and December 2007 were examined. The number of ECTs administered, seizure threshold, failure to achieve adequate seizures and clinical signs pertaining to catatonia were analyzed. Response was considered as complete resolution of catatonic symptoms with Bush Francis Catatonia Rating Scale (BFCRS) score becoming zero. ECT was mostly started after failed lorazepam treatment except in 6 patients where ECT was the first choice. Patients who responded in 4 ECT session...

Efficacy and safety of continuation and maintenance electroconvulsive therapy in depressed elderly patients: a systematic review.

Am J Geriatr Psychia... — Sun, 25 Dec 2011 08:48:51 +0100

CONCLUSIONS: : Research on this clinically important topic is sparse. On the basis of available literature, M-ECT is probably as effective as continuation medication in severely depressed elderly patients after a successful course of ECT and is generally well tolerated. To date, methodologically sound studies, which take into account important issues in geriatric depression like cognition, comorbidity, and clinical parameters, are lacking. PMID: 22183009 [PubMed - in process] (Source: Am J Geriatr Psychia...)

Two-Year Follow-Up of Cognitive Functions in Schizophrenia Spectrum Disorders of Adolescent Patients Treated with Electroconvulsive Therapy

Journal of Child and Adolescent Psychopharmacology — Fri, 23 Dec 2011 14:09:31 +0100

Journal of Child and Adolescent Psychopharmacology Dec 2011, Vol. 21, No. 6: 611-619. (Source: Journal of Child and Adolescent Psychopharmacology)

Where Does My Mental Illness End, And Where Do I Begin?

About.com Bipolar Disorder — Thu, 22 Dec 2011 14:02:04 +0100

Andy BehrmanFrom my friend Andy "Electroboy" Behrman comes a thoughtful and thought-provoking essay on the journey through life with bipolar disorder. Is there truly such a thing, he's been asked, as "recovery" from mental illness, or is apparent recovery just a matter of good coping skills? "After more than 20 years of ping-ponging between the two frightening emotional states of euphoric highs and desperate lows," Andy says, "I'm pretty sure I've come up with my answer to this challenging question." Andy's been through it all, both before and after diagnosis. Uncontrolled mania resulted in his arrest for art forgery. Treatment resistance led him to electroconvulsive therapy. He went through years of experimenting with medications to get the best combination. And he's gone from male strip...

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‘Idiopathic’ intestinal failure – the importance of identifying and treating primary psychopathology

Neurogastroenterology and Motility — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions & Inferences There is a need for additional reporting of such cases and further research. Our experience would suggest that a delay in the involvement of a specialist liaison psychiatrist has the potential to be life threatening in such cases. This may be more likely with greater severity, where the apparent predominance of ‘physical’ symptoms generates reluctance in both patient and physician to consider a psychiatric etiology and also appears to occur due to a lengthier investigative process than existed previously. We therefore propose that the provision of a specialist psychiatric assessment for all patients presenting with IF is indicated at the point of initial clinical contact, based upon the substantial clinical benefit it has the potential to confer upon a s...

Successful Treatment of Major Depression with Electroconvulsive Therapy in a Pregnant Patient with Previous Non-Response to Prefrontal rTMS

Pharmacopsychiatry — Thu, 15 Dec 2011 05:00:00 +0100

PharmacopsychiatryDOI: 10.1055/s-0031-1297936The treatment of psychiatric disorders during pregnancy poses a challenge particularly regarding limited pharmacological possibilities. Repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) have been described to be successful in single cases, however, guidelines are lacking. In order to contribute to the pool of empirical data that is necessary to create evidenced-based recommendations we present a case of successful treatment of major depression with ECT in a pregnant patient with previous non-response to rTMS.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Pharmacopsychiatry)

[Schizophrenia or Frontotemporal Dementia in a Young Chinese Female: A purview of possible diagnoses].

Turkish Journal of Psychiatry — Mon, 12 Dec 2011 13:54:02 +0100

This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed. PMID: 22143952 [PubMed - in process] (Source: Turkish Journal of Psychiatry)

Two-Year Follow-Up of Cognitive Functions in Schizophrenia Spectrum Disorders of Adolescent Patients Treated with Electroconvulsive Therapy

Journal of Child and Adolescent Psychopharmacology — Fri, 02 Dec 2011 19:31:05 +0100

Journal of Child and Adolescent Psychopharmacology , Vol. 0, No. 0. (Source: Journal of Child and Adolescent Psychopharmacology)

Electroconvulsive Therapy (ECT)

About.com Bipolar Disorder — Fri, 02 Dec 2011 05:00:00 +0100

This article covers the definition of ECT, history, the process of receiving ECT, and the controversy surrounding it. (Source: About.com Bipolar Disorder)

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The use of electroconvulsive therapy in a cohort of forensic psychiatric patients with schizophrenia

Criminal Behaviour and Mental Health — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionECT is rarely used in specialist secure services, but should not be forgotten as a treatment that may enable medication‐resistant, assaultive psychotic patients to progress safely out to the community. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Criminal Behaviour and Mental Health)

Takotsubo cardiomyopathy as a complication of electroconvulsive therapy.

The Annals of Pharmacotherapy — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Takotsubo cardiomyopathy is a serious but transient potential complication of electroconvulsive therapy. Limited evidence indicates that β-adrenergic receptor blocking agents may help prevent its reoccurrence in patients needing further electroconvulsive treatment. Health care providers in psychiatry should be aware of this potential complication of electroconvulsive therapy, especially in postmenopausal women. However, many questions remain regarding this issue. PMID: 22116995 [PubMed - in process] (Source: The Annals of Pharmacotherapy)

In this issue

Proteomics. Clinical Applications — Thu, 01 Dec 2011 05:00:00 +0100

AbstractImmunodepletion, urine analysis and diabetic nephropathypp. 603–612Diabetes mellitus is a principal cause of severe kidney disease (diabetic nephropathy (DN)) that ultimately requires an organ transplant. DN biomarkers are abundant in urine but are difficult to validate due to the presence of multiple, low abundance proteins and an excessive amount of water. Currently, 2‐D DIGE is both the most and the least reliable test for kidney disease. It produces as many as 1400 spots that must be matched, and making it the most complex. Fisher et al. add other dimensions to this analysis: chromatofocusing, electrospray, capillary electrophoresis, reversed phase liquid chromatography, and MALDI/MS. Preternatural immunity: Just hanging aroundpp. 613–623If you are so lucky as to live whe...

Electroconvulsive Therapy Today

About.com Bipolar Disorder — Mon, 28 Nov 2011 05:00:00 +0100

Almost every medical source I checked when writing this article on ECT started out by saying something like "Electroconvulsive therapy is a safe and effective treatment..." - but still there is a raging conflict about whether is is safe. Of the many horror stories I've read, though, 90% are from people who underwent ECT decades ago, and back then the treatment was administered far differently than it is now. The videos or movies you may have seen depicting people convulsing wildly during ECT are images out of the past. Today it's done under carefully controlled conditions that entirely eliminate physical seizures. Here's a look at electroconvulsive therapy - when it is most likely to be used, how the procedure is done, today's side effects and more. Electroconvulsive Therapy - Treatment ...

Brain electric shocks used to treat Alzheimer's

NHS News Feed — Fri, 25 Nov 2011 13:30:00 +0100

Conclusion This was a small, early-stage clinical study that tested the safety of using deep brain stimulation to treat Alzheimer’s disease. Due to the preliminary nature of this research and the fact it did not compare DBS patients against a control group, the results can’t be universally applied to all patients with Alzheimer’s disease. The researchers have since started a larger-scale study (involving 50 people) to assess the benefits and effectiveness of the treatment. Potential issues with this sort of study are: Without a control group it isn’t possible to say that any slowing of the deterioration expected in people with Alzheimer’s was due to the treatment. It isn’t valid to compare the results from so few people with an “expected” rate of decline. The patients...

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'Brain pacemaker' used to treat Alzheimer's

NHS News Feed — Fri, 25 Nov 2011 13:30:00 +0100

Electroconvulsive therapy article unbalanced.

cmaj — Tue, 22 Nov 2011 05:00:00 +0100

Authors: Ladha N PMID: 22106109 [PubMed - in process] (Source: cmaj)

Systematic review and meta-analysis of bifrontal electroconvulsive therapy versus bilateral and unilateral electroconvulsive therapy in depression.

The World Journal of Biological Psychiatry — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions. Bifrontal ECT is not more effective than BT or RUL ECT but may have modest short-term benefits for specific memory domains. BF ECT has potential advantages, but given longer experience with BT and RUL, bifrontal ECT requires better characterization. PMID: 22098115 [PubMed - as supplied by publisher] (Source: The World Journal of Biological Psychiatry)

Venlafaxin-Associated Post-Ictal Asystole during Electroconvulsive Therapy

Pharmacopsychiatry — Tue, 15 Nov 2011 05:00:00 +0100

We report the case of an 82-year-old female patient with a current major depressive episode, who developed the rare event of a post-ictal asystole of 6 s and 4 ventricular escape beats during ECT. In the past this patient with a bipolar disorder and mild Alzheimer’s disease had already been frequently treated with ECT with good success and no adverse events. Relevant comedication was venlafaxin, quetiapine, donepezil and clonidine, anesthesia was performed with ketamine and succinylcholine. Concurrent medication was completely unchanged compared to previous ECT sessions with the exception of venlafaxine, presumably at high serum levels. In summary, in line with some already existing reports, we expect the noradrenergic action of venlafaxin to have contributed substantially to the post-...

Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

Acta Neuropsychiatrica — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit. (Source: Acta Neuropsychiatrica)

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Predictors of Time to Relapse/Recurrence after Electroconvulsive Therapy in Patients with Major Depressive Disorder: A Population-Based Cohort Study

Infectious Diseases in Obstetrics and Gynecology — Fri, 04 Nov 2011 01:31:20 +0100

Conclusions. Within the first years after ECT, relapses/recurrences leading to hospitalisation or suicide are common. Treatment with lithium might be beneficial, while benzodiazepines, antipsychotics, or continuation ECT does not seem to significantly reduce the risk of relapse/recurrence. (Source: Infectious Diseases in Obstetrics and Gynecology)

Prolonged apnea during electroconvulsive therapy in monozygotic twins: case reports

Annals of General Psychiatry — Thu, 03 Nov 2011 04:00:00 +0100

In the present work, we report two cases of monozygotic twins who developed prolonged apnea during electroconvulsive therapy (ECT) as a complication of anesthesia. In both cases, prolonged action of succinylcholine caused by a butyrylcholinesterase (BCHE) deficiency was confirmed by means of the dibucaine number test. In both cases, genetic analysis using the polymerase chain reaction revealed haplotype combined A and K variant mutations of the BCHE gene, both in the heterozygous form. These data show the potential risk of BCHE deficiency as a complication of anesthesia during ECT, and in particular underline the possible genetic contribution within a complex pathogenetic model. (Source: Annals of General Psychiatry)

The emerging use of brain stimulation treatments for psychiatric disorders.

The Australian and New Zealand Journal of Psychiatry — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: It appears likely that the range of psychiatric treatments available for patients will grow over the coming years to progressively include a number of novel brain stimulation techniques. PMID: 22044172 [PubMed - in process] (Source: The Australian and New Zealand Journal of Psychiatry)

Electroconvulsive Therapy and Corpus Callosum Aplasia: A 3-Year Followup

Experimental Diabetes Research — Tue, 01 Nov 2011 00:27:02 +0100

We report the followup medical history of a patient with corpus callosum aplasia (or agenesis) who was continuously treated with ECT over three years. First, he improved considerably after a series of ECT, but relapses of catatonia made a continuous, weekly ECT necessary. Due to the severity of the brain malformation, an add-on medication with benzodiazepines and second generation antipsychotics was necessary to treat catatonic symptoms. This case emphasises the benefits of long-term ECT in oligophrenic patients. (Source: Experimental Diabetes Research)

Effects of maintenance electroshock on mitochondrial respiratory chain and creatine kinase activities in the rat brain

Acta Neuropsychiatrica — Mon, 31 Oct 2011 04:00:00 +0100

Conclusion: Finally, these findings further support the hypothesis that alteration on the energy metabolism could be involved in the therapeutic or adverse effects of ECS. (Source: Acta Neuropsychiatrica)

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Ictal Electroencephalographic Measures in Electroconvulsive Therapy Practice

Current Psychiatry Reviews — Fri, 28 Oct 2011 21:53:20 +0100

(Source: Current Psychiatry Reviews)

Non-Cardiogenic Pulmonary Edema Complicating Electroconvulsive Therapy: Short Review of the Pathophysiology and Diagnostic Approach.

Clinical Medicine and Research — Wed, 26 Oct 2011 04:00:00 +0100

Authors: Manne JR, Kasirye Y, Epperla N, Garcia-Montilla RJ Abstract Acute pulmonary edema complicating electroconvulsive therapy is an extremely uncommon event that has rarely been described in the literature. Different theories, including one suggesting a cardiogenic component, have been proposed to explain its genesis. The present report describes a classic presentation of this condition with review of its potential mechanisms and diagnostic approach. After successful completion of a session of electroconvulsive therapy, a 42-year-old woman with major depressive disorder developed acute systemic high blood pressure, shortness of breath, and hemoptysis. A chest radiograph demonstrated diffuse bilateral pulmonary infiltrates. Initially a cardiogenic pulmonary edema was presumed, b...

Automatic detection of seizure termination during electroconvulsive therapy using sample entropy of the electroencephalogram

Psychiatry Research — Mon, 24 Oct 2011 04:00:00 +0100

Abstract: Determining the exact duration of seizure activity is an important factor for predicting the efficacy of electroconvulsive therapy (ECT). In most cases, seizure duration is estimated manually by observing the electroencephalogram (EEG) waveform. In this article, we propose a method based on sample entropy (SampEn) that automatically detects the termination time of an ECT-induced seizure. SampEn decreases during seizure activity and has its smallest value at the boundary of seizure termination. SampEn reflects not only different states of regularity and complexity in the EEG but also changes in EEG amplitude before and after seizure activity. Using SampEn, we can more precisely determine seizure termination time and total seizure duration. (Source: Psychiatry Research)

The Reply

The American Journal of Medicine — Sun, 23 Oct 2011 00:57:20 +0100

Briggs et al from Mt Sinai wonder whether we withheld any clinical information that might have helped with a deeper understanding of the clinical implications of our study. We did not. As noted in our article, one of the patients who had an elevated cardiac troponin level had previous coronary artery bypass grafting and one patient had a positive stress test result. Had there been other associations, we would have reported them. To be clear, no cardiovascular comorbidities were detected in the other 6 patients with elevations by the internists who evaluated the patients before electroconvulsive therapy. (Source: The American Journal of Medicine)

Partial Status Epilepticus after Electroconvulsive Therapy and Medical Treatment with Bupropion

Pharmacopsychiatry — Thu, 06 Oct 2011 04:00:00 +0100

We report a patient who received right unilateral ECT under concomitant treatment with bupropion, a selective noradrenaline- and dopamine-reuptake inhibitor. After the fourth session, a focal status epilepticus occurred, which was pharmacoresistant for the duration of 12 days. We assume that the induction of a status may be facilitated by a lowering of the seizure threshold due to bupropion. An evaluation of drug therapy and control of EEG before and during ECT are recommended, especially when the drug treatment has an influence on the seizure threshold.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Pharmacopsychiatry)

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The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol

Brain — Wed, 05 Oct 2011 04:00:00 +0100

This article reviews the treatment approaches. There are no controlled or randomized studies, and so therapy has to be based on clinical reports and opinion. The published world literature on the following treatments was critically evaluated: anaesthetic agents, anti-epileptic drugs, magnesium infusion, pyridoxine, steroids and immunotherapy, ketogenic diet, hypothermia, emergency resective neurosurgery and multiple subpial transection, transcranial magnetic stimulation, vagal nerve stimulation, deep brain stimulation, electroconvulsive therapy, drainage of the cerebrospinal fluid and other older drug therapies. The importance of treating the identifying cause is stressed. A protocol and flowchart for managing super-refractory status epilepticus is suggested. In view of the small number of...

Somatic Treatments for Mood Disorders

Neuropsychopharmacology — Wed, 05 Oct 2011 04:00:00 +0100

Authors: Moacyr A Rosa & Sarah H Lisanby Keywords: biological psychiatry; depression; unipolar/bipolar; psychiatry and behavioral sciences; mood/anxiety/stress disorders; electroconvulsive therapy; vagus nerve therapy; repetitive transcranial magnetic stimulation; deep brain stimulation; transcranial direct current stimulation (Source: Neuropsychopharmacology)

Proteomic changes induced by anaesthesia and muscle relaxant treatment prior to electroconvulsive therapy

Proteomics. Clinical Applications — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions and clinical relevance: These findings indicate that caution should be used when interpreting results in existing and future proteome based biomarkers studies on the: i) effects of ECT in neuropsychiatric disease; ii) use of anaesthetic/muscle relaxant in major surgical operations related to different therapeutic areas . (Source: Proteomics. Clinical Applications)

Successful switching from sine‐wave to pulse‐wave with oral theophylline the night before electroconvulsive therapy for depression

Psychiatry and Clinical Neurosciences — Sat, 01 Oct 2011 04:00:00 +0100

(Source: Psychiatry and Clinical Neurosciences)

Safe use of electroconvulsive therapy in a highly suicidal survivor of carbon monoxide poisoning

General Hospital Psychiatry — Wed, 28 Sep 2011 04:00:00 +0100

We present a suicidal patient of CO intoxication, who received ECT safely and effectively 5 weeks after CO exposure and review the previously reported ECT-related DNS cases and the recent studies about the predictors of DNS. We propose that ECT can be safely implemented in carefully selected patients without known risk factors for DNS after an extended observation period from CO exposure. (Source: General Hospital Psychiatry)

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ECT effective for treatment-refractory schizophrenia

MedWire News - Psychiatry — Wed, 28 Sep 2011 00:00:00 +0100

Electroconvulsive therapy is an effective treatment for severely ill patients with schizophrenia who have failed to respond to other treatments, say Danish researchers. (Source: MedWire News - Psychiatry)

Neuromuscular blocking agents for electroconvulsive therapy: a systematic review

Acta Anaesthesiologica Scandinavica — Mon, 26 Sep 2011 04:00:00 +0100

Electroconvulsive therapy (ECT) is the transcutaneous application of small electrical stimuli to the brain to induce generalised seizures for the treatment of selected psychiatric disorders. The clinical indications for ECT as an effective therapeutic modality have been considerably expanded since its introduction. Anaesthesia and neuromuscular blocking agents (NMBAs) are required to ensure patients’ safety during ECT. The optimal dose of muscle relaxant for ECT reduces muscle contractions without inducing complete paralysis. Slight residual motor convulsive activity is helpful in ascertaining that a seizure has occurred, while total paralysis prolongs the procedure unnecessarily. Suxamethonium is commonly used, but nondepolarising NMBAs are indicated in patients with certain comorbiditi...

Comparison of recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex and succinylcholine during electroconvulsive therapy

Journal of Anesthesia — Fri, 23 Sep 2011 16:19:20 +0100

Conclusions This study demonstrates the efficacy of rocuronium–sugammadex as an alternative to SCC for muscle relaxation during ECT, and indicates that 8 mg/kg sugammadex produces equally rapid recovery from rocuronium muscular relaxation compared with spontaneous recovery from 1 mg/kg SCC during ECT. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00540-011-1236-yAuthors Yuji Kadoi, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanHiroko Hoshi, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanAkiko Nishida, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa...

Analysis of Target Genes Regulated by Chronic Electroconvulsive Therapy Reveals Role for Fzd6 in Depression

Biological Psychiatry — Wed, 21 Sep 2011 04:00:00 +0100

Conclusions: The results identify multiple gene targets differentially regulated by CREB binding in the hippocampus after chr-ECS and demonstrate the role of Fzd6, a Wnt receptor in behavioral models of depression. (Source: Biological Psychiatry)

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Successful use of ECT in post-stroke depression

General Hospital Psychiatry — Wed, 21 Sep 2011 04:00:00 +0100

We report the case of a 30-year-old woman with a history of stroke and antiphospholipid syndrome, who became depressed and suicidal. Neurologic and Internal Medicine consults did not reveal any contraindications to ECT, but stroke risk factor management was identified as an important measure for patient safety. The patient tolerated ECT well, reporting improvement of mood and abatement of hopelessness. This case suggests that ECT may be a safe and well-tolerated treatment for post-stroke depression. (Source: General Hospital Psychiatry)

Chronic Tinnitus following Electroconvulsive Therapy

Advances in Pharmacological Sciences — Sun, 18 Sep 2011 23:36:49 +0100

A 43-year-old female with a 27-year history of obsessive-compulsive disorder and major depression had previously been treated with psychotherapy, antidepressant, and antipsychotic medications. Because these treatments were minimally effective and because the frequency and duration of her depressive episodes continued to increase, the patient was scheduled to undergo a series of electroconvulsive therapy (ECT) procedures. The patient received four ECT treatments during one month. Stimulating current was delivered to the right frontotemporal region of the head. Electroencephalographic seizures occurred during each of the ECT procedures. After the patient recovered fro...

Administration of a selective glucocorticoid antagonist attenuates electroconvulsive shock-induced retrograde amnesia

Journal of Neural Transmission — Thu, 15 Sep 2011 15:48:30 +0100

In conclusion, these findings strengthen previous data from our laboratory implicating glucocorticoid mechanisms in ECS-induced retrograde amnesia. We suggest that the administration of a selective glucocorticoid receptor antagonist shortly before electroconvulsive therapy (ECT) treatments may attenuate the deleterious effect of ECT-induced acute hypercortisolemia on neural mechanisms involved in learning and memory. Content Type Journal ArticleCategory Basic Neurosciences, Genetics and Immunology - Original ArticlePages 1-8DOI 10.1007/s00702-011-0712-8Authors Chittaranjan Andrade, Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, 560 029 IndiaShahid Ahmad Shaikh, Department of Psychopharmacology, National Institute of Mental Heal...

Atrioventricular Dissociation after Electroconvulsive Therapy

Computational Intelligence and Neuroscience — Thu, 15 Sep 2011 15:32:33 +0100

We report a case of atrioventricular (AV) dissociation that occurred after ECT that was treated with pacemaker implantation. The mechanisms contributing to the onset of AV dissociation in this patient, and the management and rationale for device therapy, in light of the most recent guidelines, are reviewed. (Source: Computational Intelligence and Neuroscience)

Differences in cerebral blood flow between missed and generalized seizures with electroconvulsive therapy: A positron emission tomographic study

Epilepsy Research — Wed, 14 Sep 2011 04:00:00 +0100

Summary: While examining the acute effects of electroconvulsive therapy (ECT) on regional cerebral blood flow (rCBF), we could compare the changes in rCBF between missed (not generalized) and generalized seizures using H215O positron emission tomography in patients with depression under anesthesia. In contrast to missed seizures, rCBF was increased extensively, particularly in the centrencephalic structures in generalized seizures. These results further support the centrencephalic theory of seizure generalization. (Source: Epilepsy Research)

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Electroconvulsive therapy can benefit from controlled hyperventilation using a laryngeal mask

European Archives of Psychiatry and Clinical Neuroscience — Thu, 08 Sep 2011 05:54:18 +0100

Abstract Hypocapnia through hyperventilation is a well-known procedure in electroconvulsive therapy (ECT) to enhance seizure activity. However, it has mostly been applied in an uncontrolled manner. Originally intended for a better management of the supraglottic airway, laryngeal masks are more suited to monitor levels of CO2 during hyperventilation than face masks and thereby provide for the possibility of controlled hyperventilation (CHV). The impact of CHV was retrospectively studied in 114 consecutive patients; 65 of them had received ECT with CHV and 49 had received ECT with uncontrolled hyperventilation (UHV) directly prior to the time period when the laryneal mask was introduced to the ECT treatment procedure. The CO2 level in the CHV group was aimed at 30 mmHg o...

Psychogenic Unresponsiveness

Neurologic Clinics — Fri, 02 Sep 2011 04:00:00 +0100

Unresponsive patients with or without catatonic motor signs are etiologically heterogeneous, and all require a comprehensive neurodiagnostic assessment to rule out organic causes. Most cases prove to be due to primary psychiatric disorders, mostly mood disorders, especially mania, rather than schizophrenia. These patients respond to lorazepam administered by any route and, failing this, electroconvulsive therapy. Those patients with associated fever and autonomic instability are medical emergencies and need urgent treatment. (Source: Neurologic Clinics)

Succinylcholine Shortage and Electroconvulsive Therapy [Letters to the Editor]

Am J Psychiatry — Thu, 01 Sep 2011 23:00:00 +0100

(Source: Am J Psychiatry)

Treatment‐resistant depression in adolescents: review and updates on clinical management

Depression and Anxiety — Thu, 01 Sep 2011 23:00:00 +0100

AbstractTreatment‐resistant depression (TRD) in adolescents is prevalent and impairing. We here review the definition, prevalence, clinical significance, risk factors, and management of TRD in adolescents. Risk factors associated with TRD include characteristics of depression (severity, level of hopelessness, and suicidal ideation), psychiatric and medical comorbidities, environmental factors (family conflict, maternal depression, and history of abuse), and pharmacokinetics and other biomarkers. Management options include review of the adequacy of the initial treatment, re‐assessment for the above‐noted factors that might predispose to treatment resistance, switching antidepressants, and augmentation with medication or psychotherapy. Other modalities, such as electroconvulsive therap...

Succinylcholine Shortage and Electroconvulsive Therapy.

The American Journal of Psychiatry — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Maixner DF, Hermida AP, Husain MM, Rudowski MR, Reti IM PMID: 21890805 [PubMed - as supplied by publisher] (Source: The American Journal of Psychiatry)

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Electroconvulsive therapy: the name resurrected.

Canadian Journal of Psychiatry — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Kellner CH PMID: 21878164 [PubMed - in process] (Source: Canadian Journal of Psychiatry)

Re: Goldfarb JW, Bittner EA, George E, Welch C, Schmidt U. Successful management of a morbidly obese patient for electroconvulsive therapy with elective tracheostomy [J Clin Anesth 2011;23:241-3]

Journal of Clinical Anesthesia — Sat, 30 Jul 2011 14:51:20 +0100

All but one co-author (Jeremy W. Goldfarb, MD) are affiliated with Massachusetts General Hospital. Edward A. Bittner, MD, PhD (Staff Anesthesiologist), Edward George, MD, PhD (Assistant Professor of Anaesthesia), Charles Welch, MD (Associate Professor of Psychiatry), and Ulrich Schmidt, MD, PhD (Assistant Professor of Anaesthesia) are all on staff at Massachusetts General Hospital. Dr. Goldfarb, who was a Fellow in Anesthesia and Critical Care at MGH at the time the manuscript was submitted, is now Staff Anesthesiologist at Massachusetts Eye and Ear Infirmary. (Source: Journal of Clinical Anesthesia)

Continuation and Maintenance Electroconvulsive Therapy for Mood Disorders: Review of the Literature

Neuropsychobiology : Last 20 articles — Thu, 28 Jul 2011 23:00:00 +0100

Neuropsychobiology 2011;64:129–140 (DOI:10.1159/000328943) (Source: Neuropsychobiology : Last 20 articles)

Brain Effects of General Anesthesia

Psych Central — Tue, 26 Jul 2011 19:49:00 +0100

New research is shedding light on the effects of general anesthesia on the brain and the body. In the United States, nearly 60,000 patients receive general anesthesia for surgery every day. It causes specific patterns of activity in the brain, which can be viewed on an electroencephalogram (EEG). The most common pattern is a gradual rise in low-frequency, high-amplitude activity as the level of anesthesia deepens. Emery Brown, MD, of Massachusetts General Hospital believes, “How anesthetic drugs induce and maintain the behavioral states of general anesthesia is an important question in medicine and neuroscience.” His team investigated general anesthesia versus sleep and coma. They carried out a review of anesthesia studies from a range of areas, including neuroscience and sleep...

Propofol protects against impairment of learning-memory and imbalance of hippocampal Glu/GABA induced by electroconvulsive shock in depressed rats

Journal of Anesthesia — Tue, 19 Jul 2011 06:42:03 +0100

Conclusions The data suggest that propofol alleviated ECS-induced learning-memory impairment without interfering with the antidepressant efficacy of ECS, possibly by inhibiting excessive expression of GAD65 and maintaining the balance between glutamatergic and GABAergic amino acids neurotransmitters in the hippocampus. Content Type Journal ArticlePages 1-9DOI 10.1007/s00540-011-1199-zAuthors Jie Luo, Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 ChinaSu Min, Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 ChinaKe Wei, Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 ChinaPing Li,...

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Age differences in symptom expression in patients with major depression

International Journal of Geriatric Psychiatry — Mon, 18 Jul 2011 23:00:00 +0100

ConclusionsThere are age differences in symptom endorsement between younger/middle‐aged and older patients with major depression. The data, however, did not identify a symptom profile unique to late‐life depression. Copyright © 2011 John Wiley & Sons, Ltd. (Source: International Journal of Geriatric Psychiatry)

Increase of hippocampal glutamate after electroconvulsive treatment: A quantitative proton MR spectroscopy study at 9.4 T in an animal model of depression.

The World Journal of Biological Psychiatry — Sun, 17 Jul 2011 23:00:00 +0100

Conclusions. These findings support the idea of disordered hippocampal metabolism in an animal model of treatment resistant depression and suggest an early impact of ECS on MR-detectable hippocampal metabolites. PMID: 21767208 [PubMed - as supplied by publisher] (Source: The World Journal of Biological Psychiatry)

A randomized double-blind sham-controlled comparison of unilateral and bilateral repetitive transcranial magnetic stimulation for treatment-resistant major depression.

The World Journal of Biological Psychiatry — Thu, 07 Jul 2011 23:00:00 +0100

Conclusion. These findings warrant larger controlled studies that compare the efficacy of sequential bilateral rTMS and HFL rTMS in TRD. PMID: 21736507 [PubMed - as supplied by publisher] (Source: The World Journal of Biological Psychiatry)

Atypical Creutzfeldt-Jakob Disease Evolution after Electroconvulsive Therapy for Catatonic Depression

Clinical and Developmental Immunology — Sun, 03 Jul 2011 14:03:27 +0100

We describe a case report of an 80-year-old woman who presented with symptomatology compatible with an episode of major depression with catatonia. After psychiatric admission, electroconvulsive therapy (ECT) was applied, but symptoms progressed with cognitive impairment, bradykinesia, widespread stiffness, postural tremor, and gait disturbance. After compatible magnetic resonance imaging (MRI), diffusion changes, and electroencephalogram (EEG) findings the case was reoriented to Creutzfeldt-Jakob disease (CJD). The genetic study found a methionine/valine heterozygosity at codon 129 of the prion protein gene PrPSc. On followup, a significant clinical recovery turned out. For this reason, EEG and MRI were repeated and confirmed the findings. The patient subsequently demonstrated progressive ...

Another Reason to Blush: Unilateral Electroconvulsive Therapy (ECT)

The American Journal of Medicine — Fri, 01 Jul 2011 04:00:00 +0100

In the recent case report, “Stop, You're Making Me Blush,” Oller et al describe a 26-year-old woman who presented with unilateral erythema on the left side of her face. Investigation revealed the cause to be a paravertebral schwannoma. The authors discuss other possible causes of Harlequin syndrome, including internal jugular catheterization, surgical neck dissection, complication of perioperative local anesthesia, iatrogenic sympathectomy, and mediastinal and pulmonary masses. We would like to add another potential cause to this list: right unilateral electroconvulsive therapy. Some patients treated with right unilateral electroconvulsive therapy (electrodes placed on the right temple and to the right of the vertex of the skull) exhibit pronounced transient hemifacial erythema and ips...

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Troponins and Electroconvulsive Therapy (ECT): Caution in Reporting Results

The American Journal of Medicine — Fri, 01 Jul 2011 04:00:00 +0100

In the article “Troponin Elevations After Electroconvulsive Therapy: The Need for Caution,” Martinez et al provide data on the relationship between electroconvulsive therapy and troponin elevations. Such information has the ultimate goal of understanding and estimating the cardiac risks of electroconvulsive therapy. Unfortunately, because of the incomplete and somewhat complicated presentation of the data, it is impossible to conclude from the authors' study exactly where the cardiac risk lies. Of 70 patients, only 1 developed sustained cardiac troponin increases throughout the course of electroconvulsive therapy. It is not clear what this patient's cardiac risk factors were at baseline or what his/her outcome was. The authors describe 4 patients with elevated troponin levels before el...

Not-So-Deep Brain Stimulation: Transcranial Magnetic Stimulation (TMS) at Duke

DukeHealth.org: Duke Health Features — Tue, 28 Jun 2011 13:08:38 +0100

When Sarah Hollingsworth Lisanby, MD, joined Duke as the new chair of psychiatry last October, she brought with her a prodigious lab that has been instrumental in developing new devices for psychiatric disorders. Among them is a form of brain stimulation called transcranial magnetic stimulation (TMS), which, thanks to a study led by Lisanby, earned FDA approval in 2009 as a treatment for depression in patients who have failed medical therapy. “TMS has been around since 1985 as a neuroscience tool,” says Lisanby, and recent advances in bioengineering have allowed TMS to transition from a basic tool of discovery to a therapeutic application. It works on the principle of electromagnetic induction, through which magnetic fields induce electrical fields. “Powerful magnets that are turned ...

Depot Based Drug Delivery System for the Management of Depression - A Review.

Current Drug Delivery — Tue, 21 Jun 2011 23:00:00 +0100

Authors: Pilaniya U, Khatri K, Patil UK Depression is a common mental disorder discerns with depressed mood, loss of interest, the primary treatment methods are drug therapy, electroconvulsive therapy, psychotherapy, light therapy, vagus nerve stimulation, etc. A number of innovative delivery systems have been developed to address suboptimal therapy outcomes by enhancing drug delivery, assuring efficacy of treatment, reducing side effects, improving compliance and drug targeting specific locations resulting in a higher efficiency. Depot delivery offers the advantage of a very high loading, controlled release of drug for an extended period of time and reduces frequency of dosing. The increase in AUC and decrease in Cmax reflects that the depot formulations could reduce the toxic complic...

Temporary Interruption of Deep Brain Stimulation for Parkinson's Disease During Outpatient Electroconvulsive Therapy for Major Depression: A Novel Treatment Strategy [CLINICAL RESEARCH REPORTS]

J Neuropsychiatry Clin Neurosci — Tue, 14 Jun 2011 23:00:00 +0100

The safety of electroconvulsive therapy (ECT) in patients with deep brain stimulation (DBS) has not been established. Cases reported had no adverse events, but DBS was withheld throughout the weeks of the ECT course. The authors report the first case of temporary interruption of DBS only during the minutes of each outpatient ECT. (Source: J Neuropsychiatry Clin Neurosci)

Catatonia in Psychotic Patients: Clinical Features and Treatment Response [CLINICAL RESEARCH REPORTS]

J Neuropsychiatry Clin Neurosci — Tue, 14 Jun 2011 23:00:00 +0100

The authors report clinical features and treatment response in 25 patients with catatonia admitted to an inpatient psychiatric unit specializing in psychotic disorders. Electroconvulsive therapy, benzodiazepines, and clozapine had beneficial effects on catatonic features, whereas typical antipsychotics resulted in clinical worsening. (Source: J Neuropsychiatry Clin Neurosci)

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ECG changes after electroconvulsive therapy, cause or consequence?

Netherlands Heart Journal — Thu, 09 Jun 2011 23:00:00 +0100

Authors: Tuininga YS PMID: 21660671 [PubMed - as supplied by publisher] (Source: Netherlands Heart Journal)

Retrograde amnesia after electroconvulsive therapy: A temporary effect?

Journal of Affective Disorders — Wed, 08 Jun 2011 14:22:02 +0100

Conclusions: Our results are consistent with the possibility that ECT as currently practiced does not cause significant lasting retrograde amnesia, but that amnesia is mostly temporary and related to the period of impairment immediately following ECT. (Source: Journal of Affective Disorders)

The effects of continuous antidepressant treatment during the first 6months on relapse or recurrence of depression

Journal of Affective Disorders — Wed, 08 Jun 2011 14:21:57 +0100

Conclusions: Continuous antidepressant treatment and frequent follow-up visits during the acute phase were associated with a significant reduction in the likelihood of relapse or recurrence of depression. Our results provide important evidence on the effectiveness of antidepressant treatment in South Korea. (Source: Journal of Affective Disorders)

Physical treatments for bipolar disorder: A review of electroconvulsive therapy, stereotactic surgery and other brain stimulation techniques

Journal of Affective Disorders — Wed, 08 Jun 2011 14:21:51 +0100

Conclusions: ECT is an effective treatment for acute mania, bipolar depression and mixed affective states and has useful efficacy even in pharmacotherapy-resistant patients. Other brain stimulation techniques may have potential for the treatment of bipolar disorder and should be further researched. (Source: Journal of Affective Disorders)

Marked Response to VNS in a Post-Cingulotomy Patient: Implications for the Mechanism of Action of VNS in TRD.

CNS Spectrums — Tue, 31 May 2011 23:00:00 +0100

We describe the case of a woman, 53 years of age, with a long and sustained history of TRMD (33 years), which was unresponsive to numerous treatments (multiple pharmacotherapies, psychotherapy, electroconvulsive therapy [ECT]). Additionally, her TRMD failed to respond to a bilateral anterior cingulotomy. She underwent placement of a cervical vagus nerve stimulator and a brief course of ECT (3 unilateral treatments). Her depression improved markedly, and it has remained in sustained remission for 3.5 years. This case suggests a potential synergistic effect of VNS and ECT, as well as provides possible clues to the neural circuitry of VNS in TRMD. PMID: 21632014 [PubMed - as supplied by publisher] (Source: CNS Spectrums)

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Case of undiagnosed catecholaminergic polymorphic ventricular tachycardia presenting with ventricular fibrillation after administration of succinylcholine during anesthesia for modified electroconvulsive therapy

Psychiatry and Clinical Neurosciences — Tue, 31 May 2011 23:00:00 +0100

(Source: Psychiatry and Clinical Neurosciences)

Quality of life after electroconvulsive therapy in persons with treatment resistant schizophrenia.

Indian J Med Res — Tue, 31 May 2011 23:00:00 +0100

The objective of the present study was therefore, to assess the improvement in quality of life after ECT in treatment resistant schizophrenia. Methods: Thirty consecutive patients of treatment resistant schizophrenia were given ECT sessions twice a week and assessments were made with Positive and Negative Syndrome Scale of Schizophrenia (PANSS), WHO QOL Bref, Global Assessment of Functioning Scale and Clinical Global Impressions. Results: The group improved significantly on all the domains of quality of life scale except the domain named satisfaction with social relations. There was also significant change in the total score of PANSS after 6 ECT sessions (mean at baseline = 86.7, mean after 6 ECT = 65.5, P< 0.001) as well as on different subscales of PANSS. The score on the global asses...

Depression in adults: drug and physical treatments

Clinical Evidence — Wed, 25 May 2011 23:00:00 +0100

New evidence; conclusion confirmed for: Prescription antidepressant drugs (tricyclic antidepressants [including low-dose tricyclic antidepressants], SSRIs, monoamine oxidase inhibitors, or venlafaxine) versus placebo in mild to moderate or severe depression New evidence added. Categorisation unchanged (Beneficial). Tricyclic antidepressants versus each other and other prescription antidepressant drugs (SSRIs, monoamine oxidase inhibitors, or venlafaxine) in mild to moderate or severe depression New evidence added. Categorisation unchanged (Beneficia...

Position Statement: Electroconvulsive Therapy

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

Our Patients' Lives Are Worth Fighting for and Electroconvulsive Therapy (ECT) Saves Lives: A Compendium of the Evidence

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

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Electroconvulsive Therapy Does Not Damage the Brain

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

Brain Stimulation Therapies for Mood Disorders: The Continued Necessity of Electroconvulsive Therapy

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

Electroconvulsive Therapy: How Effective Is It?

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

Informed Consent and Electroconvulsive Therapy

Journal of the American Psychiatric Nurses Association — Wed, 25 May 2011 23:00:00 +0100

(Source: Journal of the American Psychiatric Nurses Association)

Rocuronium–sugammadex as an alternative to succinylcholine in electroconvulsive therapy

Journal of Anesthesia — Tue, 24 May 2011 05:52:29 +0100

Content Type Journal ArticlePages 1-1DOI 10.1007/s00540-011-1164-xAuthors Saban Yalcin, Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Yenişehir Yerleşkesi, 63300 Şanlıurfa, TurkeyHarun Aydogan, Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Yenişehir Yerleşkesi, 63300 Şanlıurfa, TurkeyHacer Serdaroglu, Department of Anesthesiology and Reanimation, Guven Hospital, Ankara, Turkey Journal Journal of AnesthesiaOnline ISSN 1438-8359Print ISSN 0913-8668 (Source: Journal of Anesthesia)

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Portrayal of ECT in Bollywood, Hollywood Films Inaccurate

Medscape Med Students Headlines — Thu, 19 May 2011 16:02:45 +0100

Depiction of electroconvulsive therapy in movies is often exaggerated and scientifically inaccurate, a qualitative analysis shows. Medscape Medical News (Source: Medscape Med Students Headlines)

Rocuronium–sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy

Journal of Anesthesia — Wed, 18 May 2011 06:17:31 +0100

Content Type Journal ArticlePages 1-1DOI 10.1007/s00540-011-1165-9Authors Yuji Kadoi, Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, Japan Journal Journal of AnesthesiaOnline ISSN 1438-8359Print ISSN 0913-8668 (Source: Journal of Anesthesia)

Electroconvulsive therapy has acute immunological and neuroendocrine effects in patients with major depressive disorder

Journal of Affective Disorders — Sun, 15 May 2011 00:27:00 +0100

Conclusions: Results suggest that acute ECT is associated with transient immunological and neuro-endocrine changes, while repeated ECT does not have an additive effect on the immune and neuroendocrine functions. (Source: Journal of Affective Disorders)

A case of nonsustained ventricular tachycardia immediately following modified electroconvulsive therapy in a depressive patient

Journal of Anesthesia — Sat, 14 May 2011 05:45:51 +0100

We describe a patient who developed ventricular tachycardia (VT) immediately after mECT. A 64-year-old man with no remarkable past history underwent a course of mECT for drug-resistant depression. Anesthesia was induced with intravenous thiopental (150 mg) followed by rocuronium (50 mg). Three minutes after the administration of rocuronium, the brain was electrically stimulated using a pulse wave. The first mECT session was performed uneventfully. However, the second session 2 days later elicited acute hypertension (182/134 mmHg) and tachycardia (130 bpm), resulting in the appearance of single and couplets of premature ventricular contractions on the electrocardiogram followed by VT lasting about 10 s. The chest was immediately compressed several times, ...

Electroconvulsive Therapy in the Spotlight

New England Journal of Medicine — Wed, 11 May 2011 21:00:06 +0100

New England Journal of Medicine, Volume 364, Issue 19, Page 1785-1787, May 2011. (Source: New England Journal of Medicine)

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Improvement in Drug-Induced Parkinsonism With Electroconvulsive Therapy.

The American Journal of Geriatric Pharmacotherapy — Mon, 09 May 2011 23:00:00 +0100

CONCLUSIONS: This was a case of probable drug-induced parkinsonism in an elderly woman who had improvement of her depression and parkinsonism after receiving ECT. PMID: 21565562 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Pharmacotherapy)

Late-life Depression: Evidence-based Treatment and Promising New Directions for Research and Clinical Practice

The Psychiatric Clinics of North America — Tue, 03 May 2011 08:21:01 +0100

This article reviews the evidence base for LLD treatment options and provides an analysis of treatment options for difficult-to-treat LLD variants (eg, psychotic depression, vascular depression). Treatment algorithms are also reviewed based on predictors of response and promising novel treatment options. (Source: The Psychiatric Clinics of North America)

[The algorithm for the biological treatment of depression in the Dutch multidisciplinary guideline on depression.]

Tijdschrift voor Psychiatrie — Fri, 29 Apr 2011 04:30:03 +0100

Authors: Spijker J, Nolen WA summary background Although antidepressants are effective in the treatment of depression, nonresponse is unfortunately a recurring problem. Treatment algorithms can help the health care professional to make consecutive step-by-step choices between the different available treatment options. aim To update the biological algorithm in the Dutch multidisciplinary guideline on the treatment of depression. method The literature was reviewed systematically. results There are five steps in the algorithm: 1. Treatment starts with an ssri, a tca, an snri, mirtaz...

Optimizing clozapine treatment

Acta Psychiatrica Scandinavica — Thu, 28 Apr 2011 08:05:01 +0100

Conclusion: Treatment with clozapine should be optimized in order to increase the rate of response and to minimize side‐effects, thus diminishing the risk of discontinuation and psychotic relapse. (Source: Acta Psychiatrica Scandinavica)

Do painkillers ‘stop Prozac working?’

NHS News Feed — Tue, 26 Apr 2011 16:13:00 +0100

Conclusion This predominantly animal research found that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen reduce the increase in p11 (a marker for depression) when mice are treated with SSRIs, which are a commonly used class of antidepressant. Furthermore, anti-inflammatories and other painkillers have been shown to reduce antidepressant behaviour in mice. The researchers followed up this study by looking at patient data. However, although they found some associations between use of anti-inflammatories and other classes of painkiller and a reduced remission rate in patients taking a particular SSRI drug (citalopram), they point out that they cannot say whether the painkillers caused this effect. They go on to say that to evaluate fully the effects of anti-inflammatories and...

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Erratum: Medical Evaluation of Patients Undergoing Electroconvulsive Therapy

New England Journal of Medicine — Wed, 20 Apr 2011 21:00:18 +0100

New England Journal of Medicine, Volume 364, Issue 16, Page 1582, April 2011. (Source: New England Journal of Medicine)

Successful management of a morbidly obese patient for electroconvulsive therapy with elective tracheostomy

Journal of Clinical Anesthesia — Tue, 19 Apr 2011 23:00:00 +0100

We report the successful airway management of a morbidly obese ECT patient via elective tracheostomy. (Source: Journal of Clinical Anesthesia)

Treating bipolar depression – antidepressants and alternatives: a critical review of the literature

Acta Neuropsychiatrica — Tue, 12 Apr 2011 23:00:00 +0100

Conclusion: In the treatment of BP depression there is not a specific effective treatment for all the patients. Interventions should therefore be personalised and the scientific evidence should be adapted to each patient's clinical features. (Source: Acta Neuropsychiatrica)

Geriatric Bipolar Disorder

The Psychiatric Clinics of North America — Tue, 12 Apr 2011 23:00:00 +0100

Because the elderly are the fastest growing segment of the population, the number of older adults with bipolar disorder is increasing. Geriatric bipolar disorder is relatively rare, with an estimated lifetime prevalence of 0.5% to 1%, although approximately 4% to 17% of older patients in clinical psychiatric settings have bipolar disorder. Bipolar elders are disproportionately affected by medical burden. Given the complex nature of this disorder, comorbidity, and behavioral disturbances, various interventions may be indicated, including pharmacotherapies, electroconvulsive therapy, psychotherapies, and integrated care models. Additional research is needed to better understand the epidemiology, phenomenology, and treatment of geriatric bipolar disorder. (Source: The Psychiatric Clinics of N...

Suxamethonium chloride/lithium: Prolonged apnoea after electroconvulsive therapy: 13 case reports

Reactions — Tue, 12 Apr 2011 16:15:37 +0100

(Source: Reactions)

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Risks and Side Effects of ECT

Psych Central — Sat, 09 Apr 2011 19:51:15 +0100

Lawrence Park, AM, MD presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are his remarks describing a research literature review of the risks and primary side effects of ECT, as published in the public record of the meeting. Key risks are defined as substantial risks of device use that could significantly influence the risk/benefit profile of the device. Mitigating factors may potentially serve as regulatory controls to adequately reduce the risk of device use such that a reasonable assurance of safety and effectiveness can be demonstrated for the device. Like the determination of potentially significant adverse events discussed in the safety review, the identif...

Katherine Kitty Dukakis on ECT

Psych Central — Sat, 09 Apr 2011 19:39:30 +0100

Katherine Kitty Dukakis presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. My name is Katherine Kitty Dukakis, and I live in Brookline, Massachusetts, except during the months of January, February, and March when my husband and I live in the westward section of Los Angeles, and he teaches at the winter quarter at UCLA. Nearly 30 years ago, in the early 1980s, I began experiencing recurring cycles of depression for no apparent reason. They would hit me every eight or nine months and last for some three or four months, and I could only describe them as being some of the most painful experiences I...

Research Findings on Memory and Cognitive Impairment in ECT

Psych Central — Fri, 08 Apr 2011 21:45:05 +0100

Dr. Peter Como presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. This presentation comes from the public record of the meeting. The FDA systematic review of the literature of cognitive adverse events [of ECT] included only randomized controlled trials as I mentioned. However, we did examine data from crossover designs if analyzable pre-crossover data were available. In addition, studies had to use standard psychometrically validated neuropsychologic tests. The statistical comparisons that were examined included comparisons among various ECT treatment conditions, such as electrode placement, energy dose, frequency of treatment, waveform, and pulse. The comparisons al...

The Reliability of ECT Machines

Psych Central — Fri, 08 Apr 2011 21:21:55 +0100

This exchange occurred during the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are the remarks as published in the public record of the meeting. MS. CARRAS: I have a question for Dr. Weiner. Dr. Weiner, I did a lot of outside reading to prepare for this appointment, and I was wondering if you could answer Linda Andre’s assertion that you have worked for companies that make electroconvulsive shock machines. DR. WEINER: Yeah, I’d be glad to answer that. Earlier in my career, I did a small amount of consulting with the device companies. As I said, I was trained in electrical engineering and systems engineering. So I was familiar with more than most psychiatrists a...

Informed Consent for ECT

Psych Central — Fri, 08 Apr 2011 21:16:22 +0100

Dr. Sarah Lisanby answered questions during the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her answers as published in the public record of the meeting. So my name is Dr. Sarah Lisanby. I’m happy to answer your question about the informed consent process for electroconvulsive therapy, which is a very detailed and important process, and guidance is given to practitioners in the APA Task Force guidelines on ECT, and it includes a sample of the informed consent document. The informed consent process is more than simply having the patient sign a form. The form itself documents a process that occurs between the clinician and the patient, and usually also family memb...

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Donald Johnson on ECT

Psych Central — Fri, 08 Apr 2011 21:12:18 +0100

Donald Johnson presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are his remarks as published in the public record of the meeting. I thank you for this opportunity. Forgive me my emotion. I was here at the FDA in 1985 and testified, and later on that year, the National Institutes of Health, the National Institute of Mental Health, had a two-day consensus conference on electroconvulsive therapy. I don’t have a memory. I don’t know if it’s because I argued with a psychiatrist and he dumped me in the locked ward and shocked me five times. I became violent. I tore my nails off grabbing onto the door, and he said after five times, he says, sometime...

Mary Rosedale on ECT

Psych Central — Fri, 08 Apr 2011 21:10:09 +0100

Mary Rosedale presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. My name is Mary Rosedale. I’m a board certified psychiatric nurse practitioner and an Assistant Professor of Nursing, and I’m here as a representative of the American Psychiatric Nurses Association which has prepared a position statement on this issue. The American Psychiatric Nurses Association, APNA, was founded in 1986 and is the largest professional association of psychiatric nurses representing both psychiatric nurses at the basic level of practice, RNs, and psychiatric nurse practitioners and psychiatric clinical n...

Dr. David Boger on ECT

Psych Central — Fri, 08 Apr 2011 21:08:26 +0100

Dr. David Boger presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are his remarks as published in the public record of the meeting. Good afternoon. My name is Dr. David Boger. I’m a board certified adult psychiatrist in private practice in New York City. I come to you today both as a physician who supports the use of ECT in carefully selected patient populations and as a patient myself who has undergone extensive electroconvulsive therapy. I refer you to my personal article I wrote entitled, “Shocking the Shrink: A Psychiatrist Undergoes ECT.” I’ve experienced episodic depressions characterized by sleep and appetite disturbance, impaired...

Lauren Tenney on ECT

Psych Central — Fri, 08 Apr 2011 21:07:01 +0100

Lauren Tenney presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. Hi, thanks. My name is Lauren Tenney. I’m a survivor of psychiatry. I was never given electroshock, but it’s much because of the work of advocates and activists in the 1960s and 1970s and 1980s that prevented me from being exposed to the treatment which is known to cause brain damage, including memory loss, damage to the body, and destruction of life. I consider myself very lucky. At 15 I was institutionalized at a state facility in New York, and in recent meetings, as recent as the end of last year, the New York State Of...

Carol Jean Reynolds on ECT

Psych Central — Fri, 08 Apr 2011 21:05:43 +0100

Carol Jean Reynolds presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. Thank you for permitting me as well as other members of the public to provide comments at this important meeting. I would first like to applaud this Panel for coming together on a matter of critical importance to people with disabilities. I’m here in my capacity as a board member of the National Council on Disability, an independent federal agency which advises the President and Congress on all issues affecting people with disabilities. I also want to let you know that I’m a psychiatric survivor myself and therefore...

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Dr. Daniel Fisher on ECT

Psych Central — Fri, 08 Apr 2011 21:04:06 +0100

This study provides the first evidence in a large prospective sample that adverse cognitive effects can exist for an extended period and that they characterize routine treatment by ECT in community settings.” The APA guidelines for ECT inaccurately contend that the memory loss with ECT is minimal. Furthermore, the APA consent form drastically underestimates mortality associated with ECT by stating a risk of 1 in 10,000, whereas the average of numerous studies indicated a tenfold higher rate of death than suggested by the APA. The APA also suggests that “Brain damage should not be included in the informed consent process as a risk of treatment.” It appears the APA Task Force on ECT overlooked considerable evidence that ECT does produce brain damage as summarized by neu...

Dorothy Dundas on ECT

Psych Central — Fri, 08 Apr 2011 21:02:07 +0100

Dorothy Dundas presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. My name is Dorothy Dundas, and I am 69 years old from Newton, Massachusetts, and I’ve been waiting 50 years to come before this Panel, those of you who have a power to make a humane decision. When I was 19 years old, I became sad and lonely, and I tried to kill myself. I took a half a bottle of aspirin, my parents took me to the Massachusetts General Hospital, and thus began my three-year hellish odyssey as a prisoner in the horrors of the mental health system. I was diagnosed with schizophrenia and given 50 shock treatments a...

Evelyn Scogin on ECT

Psych Central — Fri, 08 Apr 2011 21:00:26 +0100

Evelyn Scogin presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. My name is Evelyn Scogin. I’m here to tell you my story of assault from ECT so that you will understand the harm this machine does every time it is used. I came to psychiatry in 2004 at the age of 47. I was experiencing severe stressors at the time. So I naturally turned to a mental health professional for assistance and advice. I entered the psychiatric system at the time, trusting the psychiatrist as the health professional that would care for me in my time of need and perhaps help me solve my emotional issues. That is what I w...

Amy Lutz on ECT

Psych Central — Fri, 08 Apr 2011 20:57:39 +0100

Amy Lutz presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. Thank you, members of the Panel. My name is Amy Lutz, and my son, Jonah, suffers from autism and rapid cycling bipolar disorder. Until last March, he was plagued by frequent, unpredictable, and violent rages during which he would pound himself in the face like this until he looked like this. I’m showing you these pictures because I need you to understand the state of crisis we lived in for the better part of a decade, and even worse than what he would do to himself was what Jonah would do to others when he was in one of these states. ...

Anita Hagin on ECT

Psych Central — Fri, 08 Apr 2011 20:55:55 +0100

Psychiatric nurse Anita Hagin presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. Thank you for this opportunity to speak to the Panel. I’m a psychiatric nurse at Sheppard Pratt Health System, and I came on my day off to express my concern about this issue. For over 20 years, I have been a registered nurse working with patients receiving ECT. It has been a career of helping people. I can say that I look forward to going to work each day and having the privilege of helping someone battling depression get relief from their symptoms when medications have proven ineffective. ECT is a treatment ...

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Dr. John Breeding on ECT

Psych Central — Fri, 08 Apr 2011 20:53:25 +0100

Dr. John Breeding presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are his remarks as published in the public record of the meeting. My name is John Breeding. I’ve been a Texas psychologist for almost 30 years, and I’m a founding member of the Coalition for the Abolition of Electroshock in Texas. I’ve been active for 20 years in efforts to abolish or at least limit the use of electroshock because of its severe danger and lack of efficacy. Although we narrowly failed to accomplish a total ban on electroshock in Texas, the procedure is banned for children under age 16 and extra safeguards are in place for the elderly. In Texas at least, we know t...

Julie Hersh on ECT

Psych Central — Fri, 08 Apr 2011 20:51:49 +0100

Julie Hersh presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting. Hi. I’m Julie Hersh, and I am an ECT patient, and I’m part of the silent majority of those who have greatly benefited from ECT. In 2001, after nine months of debilitating clinical depression and three suicide attempts, I did ECT at the insistence of my psychiatrist and my husband. The results for me were miraculous. I can remember the day after my first treatment, opening up my journal and looking at the page and thinking, who is this person? I just felt so completely differently from the point that I wanted to die to sudde...

Expert consensus on hospitalization for assessment: a survey in Japan for a new forensic mental health system

Annals of General Psychiatry — Thu, 07 Apr 2011 23:00:00 +0100

Conclusions: The consensus regarding hospitalization for assessment and its associated problems were clarified. The consensus should be widely publicized among practitioners to ensure better management during the hospitalization of mentally disordered offenders for assessment. (Source: Annals of General Psychiatry)

Endocrine Psychiatry: The Dexamethasone Suppression Test and Electroconvulsive Therapy

Psychiatric Times — Thu, 07 Apr 2011 18:00:01 +0100

Electroconvulsive therapy (ECT) is making something of a comeback because it remains a paragon of efficacy amidst other relatively disappointing treatments. (Source: Psychiatric Times)

Electroconvulsive therapy and suicide among the mentally ill in England: A national clinical survey

Psychiatry Research — Fri, 01 Apr 2011 14:06:15 +0100

Abstract: We aimed to determine the number and characteristics of psychiatric patients receiving electroconvulsive therapy (ECT) who had subsequently died by suicide. Data were collected on an 8-year (1999–2006) sample of suicide cases in England who had been in recent contact with mental health services. Of 9752 suicides, 71 (1%) were being treated with ECT at the time of death. Although the number of patients who received ECT had fallen substantially over time, the rate of suicide in these individuals showed no clear decrease and averaged 9 deaths per year, or a rate of 10.8 per 10,000 patients treated. These suicide cases were typically older, with high rates of affective disorder and previous self-harm. They were more likely to be an in-patient at the time of death than other suicide...

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Successful treatment with maintenance electroconvulsive therapy for a patient with medication‐resistant rapid cycling bipolar disorder

Psychiatry and Clinical Neurosciences — Thu, 31 Mar 2011 23:00:00 +0100

(Source: Psychiatry and Clinical Neurosciences)

Predictors of response to ultrabrief right unilateral electroconvulsive therapy

Journal of Affective Disorders — Tue, 29 Mar 2011 18:28:46 +0100

Conclusions: This preliminary study suggests that predictors of response for ultrabrief RUL ECT are similar to those identified for other types of ECT previously studied. (Source: Journal of Affective Disorders)

Electroconvulsive therapy for major depression within the Veterans Health Administration

Journal of Affective Disorders — Tue, 29 Mar 2011 18:28:43 +0100

Conclusions: ECT use for major depression was relatively uncommon. Race, US region, geographic accessibility, and general medical health were all associated with whether or not patients received ECT. Clinicians and health systems should work to provide equitable access and more consistent use of this safe and effective treatment. (Source: Journal of Affective Disorders)

Episode length and mixed features as predictors of ECT nonresponse in patients with medication-resistant major depression

Mon, 21 Mar 2011 04:00:00 +0100

Conclusions: ECT was an effective treatment for approximately two-thirds of the patients with medication-resistant depression who were included in this study. ECT nonresponse was associated with bipolar subtype, presence of manic symptoms during depression, slightly less severe depressive symptomatology, and protracted duration of the episode. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)

Kleine-Levine syndrome in an adolescent female and response to modafinil

Annals of Indian Academy of Neurology — Tue, 15 Mar 2011 00:00:00 +0100

Ashish Aggarwal, Amit Garg, RC JilohaAnnals of Indian Academy of Neurology 2011 14(1):50-52Kleine-Levine Syndrome (KLS) is a disorder characterized by a triad of periodic hypersomnia, hyperphagia, and hypersexuality. KLS, although more common in young males, it has also been seen in females. Treatment options available for its management include mood stabilisers like lithium, stimulants like amphetamines, antidepressants and other options including electroconvulsive therapy. Modafinil is one of the new stimulant medications approved for narcolepsy. Herein, we report a young female with KLS and showing favorable response to modafinil. More data is required to establish the effectiveness of modafinil in this syndrome. (Source: Annals of Indian Academy of Neurology)

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Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study

European Archives of Psychiatry and Clinical Neuroscience — Sat, 12 Mar 2011 16:52:42 +0100

Abstract In a retrospective chart review, we examined the effects of ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, as electroconvulsive therapy (ECT) anaesthetic in patients suffering from therapy-resistant depression. We included 42 patients who received ECT treatment with either ketamine (n = 16) or the barbiturate thiopental (n = 26). We analysed the number of sessions until completion of ECT treatment (used as a surrogate parameter for outcome), psychopathology as assessed by pre- and post-ECT Mini-Mental State Examination (MMSE) and Hamilton Rating Scale for Depression (HAM-D) scores as well as ECT and seizure parameters (stimulation dose, seizure duration and concordance, urapidil dosage for post-seizure blood pressure management). ...

ECT use most common in western counties

The Irish Times - Health — Tue, 01 Mar 2011 00:21:41 +0100

Under 400 patients received a total of 2,672 treatments of electroconvulsive therapy in hospitals during 2009, figures from Mental Health Commission show (Source: The Irish Times - Health)

Troponin Elevations After Electroconvulsive Therapy: The Need for Caution

The American Journal of Medicine — Tue, 01 Mar 2011 00:00:00 +0100

Conclusions: Elevations of cTn occurred in 11.5% of patients treated with electroconvulsive therapy. Some of the elevations preceded therapy and some occurred during treatment. Given the adverse prognostic importance of cTn elevations in general, in addition to additional studies, an increased degree of medical scrutiny may be appropriate for this group of patients and for those receiving electroconvulsive therapy. © 2011 Elsevier Inc. All rights reserved. (Source: The American Journal of Medicine)

Chronic unipolar mania. A case report.

Actas Espanolas de Psiquiatria — Tue, 01 Mar 2011 00:00:00 +0100

Conclusions. Chronic unipolar mania is a clinical entity appearing as a residual characteristic in the current psychiatric nosology. Its low prevalence makes it difficult to carry out research aimed at elucidating whether it has a subordinate or independent relationship with the bipolar disorder. A systematic assessment of the effectiveness of electroconvulsive therapy is needed in these patients. Keywords: Chronic unipolar mania, bipolar disorder, eletroconvulsive therapy. PMID: 21404154 [PubMed - in process] (Source: Actas Espanolas de Psiquiatria)

Regional variation in electroconvulsive therapy use.

Ir Med J — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Dunne R, McLoughlin DM Although electroconvulsive therapy (ECT) is the most powerful treatment for depression, substantial variability in use has been described in Ireland. The Mental Health Commission collects usage data from approved centres but does not include home addresses or independent sector patients. Therefore, estimates of regional variation cannot be accurate, e.g. 145 (35% of total) independent sector patients were omitted from their 2008 analysis. When public and independent sector patients are combined inter-regional variation for 2008 is more than halved (chi-squared decreased from 83 to 30), with Western region contributing most to variation (chi-squared = 43). Ratio of ECT programmes to depressed admissions correlated negatively with rate for depressed admiss...

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ECT in a patient with Parkinson’s disease and schizophrenia, with dopamine transporter visualisation using 123I-Ioflupane SPET

Journal of Neural Transmission — Sat, 26 Feb 2011 21:40:46 +0100

Abstract A 58-year old woman with chronic schizophrenia developed worsening parkinsonian symptoms over the previous 6 years, and was eventually diagnosed as having Parkinson’s disease. Antipsychotics were stopped because they worsened these symptoms. Antiparkinsonian treatment led to a significant increase in delusions and behavioural disorganisation. The patient underwent electroconvulsive-therapy which improved both her psychiatric and motor symptoms. After treatment, 123I-Ioflupane uptake was mildly increased in the left caudate nucleus, but uptake in right caudate nucleus was lower than in a pretreatment scan. Content Type Journal ArticlePages 1-4DOI 10.1007/s00702-011-0615-8Authors Paloma Fernández-Corcuera, Aguts Unit, Benito Menni Hospital, c/Antoni Puj...

Public attitudes towards electroconvulsive therapy in the Chuvash Republic.

The International Journal of Social Psychiatry — Mon, 21 Feb 2011 00:00:00 +0100

CONCLUSION: Limited information about and generally negative attitudes towards ECT were found in the general population of the Chuvash Republic. Gender, age, education level, employment in the health industry, and information source were found to be the determining factors in the knowledge of and attitudes towards ECT. PMID: 21339235 [PubMed - as supplied by publisher] (Source: The International Journal of Social Psychiatry)

Successful ECT treatment for medically refractory nonconvulsive status epilepticus in pediatric patient

Seizure: European Journal of Epilepsy — Fri, 18 Feb 2011 00:00:00 +0100

We describe a 7-year-old pediatric case in which ECT was used successfully to treat medically refractory nonconvulsive status epilepticus (NCSE) without complete withdrawal of antiepileptic drugs (AED). (Source: Seizure: European Journal of Epilepsy)

Ictal physiological characteristics of remitters during bilateral electroconvulsive therapy

Psychiatry Research — Sun, 13 Feb 2011 02:52:31 +0100

Abstract: Ictal heart rate (HR) and postictal suppression in ictal EEG are believed to be predictive of the therapeutic efficacy of eletroconvulsive therapy (ECT) for depression. However, regarding ictal peak HR, previous studies investigated ictal HR on only one or two occasions during the course of ECT. We prospectively examined whether two physiological parameters, ictal peak HR and postictal suppression in ictal EEG, during every session, including those with abortive seizure, predicted ECT efficacy. Ictal peak HR and postictal suppression index were analyzed in 53 consecutive inpatients with depression using generalized estimating equations analysis, which corrects for the repeated nature of the observations. The peak HR and postictal suppression index were associated with therapeutic...

Electroconvulsive Therapy: The Second Most Controversial Medical Procedure

Psychiatric Times — Tue, 08 Feb 2011 12:00:00 +0100

ECT, like abortion, is surrounded by controversy and strong opinions on both sides. Fortunately, for those of us who practice ECT, the discussion is not quite as heated nor the risks as high as for our colleagues in ob-gyn. (Source: Psychiatric Times)

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Transient increase of plasma concentrations of amyloid β peptides after electroconvulsive therapy

Tue, 08 Feb 2011 05:00:00 +0100

Conclusion: Different physiologic phenomena may be responsible for the transient increase of the Aβ peptides concentrations in plasma shortly after ECT session, and further studies are necessary to explain these mechanisms. For example, decreased integrity of the blood-brain barrier permeability, an increased release from neurons due to their activation or increased release from peripheral sources, like thrombocytes or muscles, or a combination of different factors must be taken into consideration. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)

Time course and duration of changes in Kv7.2 and Kv11.1 mRNA expression in the hippocampus and piriform cortex following electroconvulsive stimulations

Tue, 08 Feb 2011 05:00:00 +0100

Conclusions: These results indicate that the changes in Kv7.2 and Kv11.1 channels may contribute to the therapeutic effect of ECT. However, further research needs to be undertaken in this area to extend these findings. (Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation)

Rapid Control of Manic Symptoms During Combination of Electroconvulsive Therapy and Lithium [LETTERS TO THE EDITOR]

J Neuropsychiatry Clin Neurosci — Tue, 08 Feb 2011 00:00:00 +0100

(Source: J Neuropsychiatry Clin Neurosci)

Use of rocuronium–sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy

Journal of Anesthesia — Fri, 04 Feb 2011 09:21:15 +0100

In conclusion, this study demonstrates the potential benefit of use of rocuronium–sugammadex as an alternative to succinylcholine for muscle relaxation during ECT. Content Type Journal ArticlePages 1-5DOI 10.1007/s00540-011-1095-6Authors Hiroko Hoshi, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanYuji Kadoi, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanJiro Kamiyama, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanAkiko Nishida, Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, JapanHiroyuki Saito,...

FDA Panel Wants Electroconvulsive Therapy to Retain High-Risk Class III Status

Medscape Today Headlines — Wed, 02 Feb 2011 13:06:22 +0100

The US Food and Drug Administration's Neurological Devices Panel wants electroconvulsive therapy devices to retain their high-risk class III classification. Medscape Medical News (Source: Medscape Today Headlines)

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FDA panel deems electroshock devices high risk

CNN.com - Health — Tue, 01 Feb 2011 17:53:19 +0100

An advisory panel to the Food and Drug Administration has recommended that devices used in electroconvulsive therapy - also known as "electroshock therapy"- should continue to be classified as high risk. (Source: CNN.com - Health)

Evaluation of an electroconvulsive therapy service in a general hospital

International Journal of Mental Health Nursing — Tue, 01 Feb 2011 00:00:00 +0100

This study has shown that auditing of ECT practices and services by mental health nurses is essential for quality improvement processes. The audit highlighted areas of service delivery that should be subject to review and evaluation against professional standards. (Source: International Journal of Mental Health Nursing)

Patients Need Continuing Access To Life-Saving Treatment

Health News from Medical News Today — Mon, 31 Jan 2011 11:00:00 +0100

The American Psychiatric Association is pleased that patients will continue to have access to life-saving Electroconvulsive Therapy (ECT) following an FDA advisory panel's two-day discussion about a possible reclassification of ECT devices. "We're optimistic that this life-saving procedure will continue to be available as a treatment option for patients with debilitating illnesses," said APA President Carol Bernstein, M.D. "ECT is appropriate for a small percentage of patients, generally those with severe mental illnesses that have not responded to other treatments... (Source: Health News from Medical News Today)

Electroconvulsive Therapy Under New Scrutiny

MedicineNet Senior Health General — Mon, 31 Jan 2011 07:00:00 +0100

Title: Electroconvulsive Therapy Under New ScrutinyCategory: Health NewsCreated: 1/29/2011 11:00:00 AMLast Editorial Review: 1/31/2011 (Source: MedicineNet Senior Health General)

FDA Panel: Keep ECT Devices as High Risk

MedPage Today Psychiatry — Sat, 29 Jan 2011 00:13:45 +0100

(MedPage Today) -- GAITHERSBURG, Md. -- The FDA should continue to regulate electroconvulsive therapy (ECT) machines as high-risk devices for treating depression and most other conditions for which ECT is typically used, members of the agency's Neurological Devices Advisory Committee agreed. (Source: MedPage Today Psychiatry)

Electroconvulsive Therapy Under New Scrutiny

WebMD Health — Fri, 28 Jan 2011 05:00:00 +0100

The recommendations of an FDA advisory panel could mean new restrictions on electroconvulsive therapy -- a controversial treatment used by tens of thousands of U.S. patients with severe depression and other mental disorders. (Source: WebMD Health)

Chronic repetitive transcranial magnetic stimulation increases hippocampal neurogenesis in rats

Psychiatry and Clinical Neurosciences — Wed, 26 Jan 2011 18:13:12 +0100

Conclusion: Our results suggest that hippocampal neurogenesis might be involved in the antidepressant effects of chronic rTMS. (Source: Psychiatry and Clinical Neurosciences)