Bi-temporal electroconvulsive therapy efficacy in bipolar and unipolar depression: A retrospective comparison

2021 ◽  
Vol 55 ◽  
pp. 102503
Author(s):  
S. Can Gurel ◽  
Emre Mutlu ◽  
Koray Başar ◽  
M. Kazım Yazıcı
Keyword(s):  
Electroconvulsive Therapy ◽  
Unipolar Depression ◽  
Therapy Efficacy ◽  
Retrospective Comparison

Declining Use of Electroconvulsive Therapy in U.S. General Hospitals Is Not Restricted to Unipolar Depression

2013 ◽  
Vol 74 (10) ◽  
pp. e19-e20 ◽  
Author(s):  
Brady G. Case ◽  
David N. Bertollo ◽  
Eugene M. Laska ◽  
Lawrence H. Price ◽  
Carole E. Siegel ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Unipolar Depression ◽  
General Hospitals

scholarly journals Use of Electroconvulsive Therapy in Adolescents: A Retrospective Study

2020 ◽  
pp. 025371762095673
Author(s):  
Sandeep Grover ◽  
Venkatesh Raju ◽  
Subho Chakrabarti ◽  
Akhilesh Sharma ◽  
Ruchita Shah ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Retrospective Chart Review ◽  
Unipolar Depression ◽  
Percentage Improvement ◽  
Number Of Patients ◽  
Common Diagnosis ◽  
The Mean ◽  
Pressure Changes

Background: This study aimed to evaluate the clinical profile of adolescents aged up to 19 years who had received electroconvulsive therapy (ECT). Methods: A retrospective chart review was carried out to identify adolescents aged up to 19 years who had received ECT during the period 2012–2018. Details regarding their sociodemographic and clinical variables and ECT data were extracted from the records. Results: During the study period, a total of 51 adolescents received ECT, and complete records of 50 patients were available for analysis. 4.04% (51 out of 1260) of the patients who received ECT were aged up to 19 years. There was a decreasing trend of use of ECT over the years. The most common diagnosis was schizophrenia (42%), and this was followed by bipolar disorder (22%) and unipolar depression (20%). The mean number of ECTs administered per patient was 8.84 (SD: 5.34; range: 1–21). On the various rating scales, the percentage improvement in patients with psychotic disorders was 77.4%. For patients with depression, the percentage improvement was 77.2%, and that for mania was 80.3%. The percentage improvement in organic catatonia was 64.6%. The number of patients achieving ≥50% response ranged from 87.5% to 100%, and when the response was defined as ≥75% improvement, the proportion of patients varied from 50% to 76.9%. The majority of patients with depression (72.7%) and mania (77.8%) achieved remission. Immediate complications associated with the use of ECT included acute blood pressure changes (18%). Conclusion: ECT is effective and safe in adolescents with severe mental disorders. The clinician should not hesitate and delay the use of ECT in adolescents who require it.

scholarly journals Lithium for suicide and readmission prevention after electroconvulsive therapy for unipolar depression: population-based register study

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Ole Brus ◽  
Yang Cao ◽  
Åsa Hammar ◽  
Mikael Landén ◽  
Johan Lundberg ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Suicide Attempts ◽  
Cox Regression ◽  
Lithium Treatment ◽  
Unipolar Depression ◽  
Population Based ◽  
Register Study ◽  
Quality Register ◽  
National Quality ◽  
History Of

Background Electroconvulsive therapy (ECT) is effective for unipolar depression but relapse and suicide are significant challenges. Lithium could potentially lower these risks, but is used only in a minority of patients. Aims This study quantifies the effect of lithium on risk of suicide and readmission and identifies factors that are associate with readmission and suicide. Method This population-based register study used data from the Swedish National Quality Register for ECT and other Swedish national registers. Patients who have received ECT for unipolar depression as in-patients between 2011 and 2016 were followed until death, readmission to hospital or the termination of the study at the end of 2016. Cox regression was used to estimate hazard ratios (HR) of readmission and suicide in adjusted models. Results Out of 7350 patients, 56 died by suicide and 4203 were readmitted. Lithium was prescribed to 638 (9%) patients. Mean follow-up was 1.4 years. Lithium was significantly associated with lower risk of suicide (P = 0.014) and readmission (HR 0.84 95% CI 0.75–0.93). The number needed to be treated with lithium to prevent one readmission was 16. In addition, the following factors were statistically associated with suicide: male gender, being a widow, substance use disorder and a history of suicide attempts. Readmission was associated with young age, being divorced or unemployed, comorbid anxiety disorder, nonpsychotic depression, more severe symptoms before ECT, no improvement with ECT, not receiving continuation ECT or antidepressants, usage of antipsychotics, anxiolytics or benzodiazepines, severity of medication resistance and number of previous admissions. Conclusions More patients could benefit from lithium treatment. Declaration of interest None.

scholarly journals Variation of plasma cortisol levels in patients with depression after treatment with bilateral electroconvulsive therapy

2015 ◽  
Vol 37 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Daniel Fortunato Burgese ◽  
Débora Pastore Bassitt
Keyword(s):  
Mental Disorders ◽  
Electroconvulsive Therapy ◽  
Mechanism Of Action ◽  
Unipolar Depression ◽  
Therapeutic Modality ◽  
Control Group ◽  
Blood Levels ◽  
Depression Symptoms ◽  
Potential Contribution ◽  
Cortisol Levels

Introduction: More than 60 years after the introduction of modern psychopharmacology, electroconvulsive therapy (ECT) continues to be an essential therapeutic modality in the treatment of mental disorders, but its mechanism of action remains unclear. Hormones play an essential role in the development and expression of a series of behavioral changes. One aspect of the influence of hormones on behavior is their potential contribution to the pathophysiology of psychiatric disorders and the mechanism of action of psychotropic drugs and ECT.Objective: We measured blood levels of the hormone cortisol in patients with unipolar depression according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and compared results with levels found in healthy adults.Method: Blood cortisol levels were measured before the beginning of treatment with ECT, at the seventh session, and at the last session, at treatment completion. Depression symptoms were assessed using the Beck Depression Inventory (BDI).Results: Cortisol levels remained stable in both men and women between the seventh and the last sessions of ECT; values ranged from 0.686±9.6330 g/dL for women, and there was a mean decrease of 5.825±6.0780 g/dL (p = 0.024). Mean number of ECT sessions was 12. After the seventh and the last ECT sessions, patients with depression and individuals in the control group had similar cortisol levels, whereas BDI scores remained different.Conclusion: Cortisol levels decreased during ECT treatment. ECT seems to act as a regulator of the hypothalamic-pituitaryadrenal axis.

scholarly journals Accelerated intermittent theta burst as a substitute for patients needing electroconvulsive therapy during the COVID-19 pandemic: study protocol for an open-label clinical trial

2020 ◽  
Author(s):  
Daniel M. Blumberger ◽  
Zafiris J. Daskalakis ◽  
Fidel Vila-Rodriguez ◽  
David Boivin-Lafleur ◽  
Michelle S. Goodman ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Outcomes ◽  
Electroconvulsive Therapy ◽  
Relapse Prevention ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Unipolar Depression ◽  
High Dose ◽  
Treatment Schedule ◽  
Open Label ◽  
Theta Burst

Abstract Background Treatment resistant depression (TRD) is one of the leading causes of disability in Canada and is associated with significant societal costs. Repetitive transcranial magnetic stimulation (rTMS) is an approved, safe, and well-tolerated intervention for TRD. In the setting of the COVID-19 pandemic, reducing the number of visits to the clinic is a potential approach to significantly minimize exposure and transmission risks to patients. This can be accomplished by administering multiple treatment sessions in a single day, using an rTMS protocol known as accelerated intermittent theta burst stimulation (aiTBS). The objective of this novel study is to assess the feasibility, acceptance and clinical outcomes of a practical high-dose aiTBS protocol, including tapering treatments and symptom-based relapse prevention treatments, in patients with unipolar depression previously responsive to electroconvulsive therapy (ECT) or patients warranting ECT due to symptom severity. Methods All patients with unipolar depression referred to the brain stimulation service at the Centre for Addiction and Mental Health (CAMH) who warrant ECT will be offered screening to assess for eligibility to enroll in this trial. This open label, single group trial consists of 3 phases. In the acute treatment phase, treatment will occur 8 times daily for 5 days a week, until symptom remission is achieved or a maximum of 10 days of treatment. In the tapering phase, treatments will be reduced to 2 treatment days per week for 2 weeks, followed by 1 treatment day per week for 2 weeks. Patients will then enter the symptom-based relapse prevention phase including virtual check-ins and a treatment schedule based on symptom level. Remission, response and change in scores on several clinical measures from baseline to the end of the acute, tapering and relapse prevention phases represent the clinical outcomes of interest. Discussion Findings from this novel clinical trial may provide support for the use of aiTBS, including tapering treatments and symptom-based relapse prevention treatments, as a safe and effective alternative intervention for patients needing ECT during the COVID-19 pandemic. Trial registration Clinicaltrials.gov: NCT04384965

Electroconvulsive therapy in elderly - a preliminary study

2016 ◽  
Vol 33 (S1) ◽  
pp. s230-s230
Author(s):  
C. Agostinho ◽  
M. Duarte ◽  
R. Alves ◽  
I. Cunha ◽  
A.M. Batista
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Severe Depression ◽  
Unipolar Depression ◽  
Normal Range ◽  
Significant Difference ◽  
The Mean ◽  
Preliminary Study ◽  
Competing Interest

IntroductionStudies with electroconvulsive therapy (ECT) in elderly focus mainly on the assessment of possible side effects on the cognitive functioning; there are few studies that evaluate the effectiveness.ObjectiveEvaluate the effectiveness of this treatment in the population over 65 years.AimsPerform a preliminary study to evaluate the response to ECT of ≥ 65 years patients with depression.MethodsWe carry out a descriptive study based on patients treated in the last 10 years in the ECT Unit of Centro Hospitalar Psiquiátrico de Lisboa.ResultsOur initial sample consisted of 457 patients. We select patients aged ≥ 65 years with depression, and with complete data, including electroconvulsive parameters, and initial and final Hamilton Rating Scale for Depression (HRSD) scores (n = 59). Of this, 81.36% (n = 48) had unipolar depression, and 18.64% (n = 11) had bipolar depression. In the first group, the mean variation between the initial and final scores in HRSD was 13.88 points, and 27.10% (n = 13) of the patients ended the treatment in the normal range of HRSD score. In the second group, the mean variation was 12.82, and 63.60% (n = 7) ended the treatment in the normal range of HRSD. Considering the initial and final HRSD scores, it appears that unipolar depression group presents higher values (severe depression) (P < 0.05). When we compare the mean variation between the initial and final HRSD scores, we didn’t observe a statistically significant difference between the two groups. There was a clinical improvement in both.ConclusionsThe acute treatment with ECT appears to improve depressive symptoms in bipolar and unipolar depression, when considering an elderly population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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