Comparison of methohexital and etomidate as anesthetic agents for electroconvulsive therapy in affective and psychotic disorders

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.

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Somatic Treatments for Psychotic Disorders

10.1093/med/9780199331505.003.0006 ◽

2016 ◽

Author(s):

Justin C. Ellison ◽

Jason B. Rosenstock ◽

Michael J. Marcsisin

Keyword(s):

Side Effects ◽

Electroconvulsive Therapy ◽

Gold Standard ◽

Psychotic Disorders ◽

Mood Stabilizers ◽

Positive Symptoms ◽

Second Generation Antipsychotics ◽

Treatment Refractory ◽

Long Acting ◽

Somatic Therapies

A variety of somatic therapies can be used to treat individuals suffering from psychosis. Most commonly, providers will prescribe antipsychotics, which generally block dopamine receptors and are particularly useful at reducing positive symptoms. Second-generation antipsychotics have fewer movement side effects than older agents do, but they are more expensive and have more metabolic side effects. Long-acting injectable (LAI) antipsychotics can be useful for improving outcomes, especially in non-adherent patients, and clozapine is the gold standard for treatment-refractory psychosis. Other agents may be useful for adjunct therapy, or in early psychosis, such as antidepressants, mood stabilizers, and benzodiazepines. In this chapter, we will also review other somatic therapies such as electroconvulsive therapy (ECT) and other neuromodulation approaches.

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Does Gender Influence Electroconvulsive Therapy Sessions Required across Psychiatric Diagnoses? A 5-Year Experience from a Single Center

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_482_16 ◽

2017 ◽

Vol 08 (03) ◽

pp. 427-430 ◽

Cited By ~ 4

Author(s):

Harshini Manohar ◽

Karthick Subramanian ◽

Vikas Menon ◽

Shivanand Kattimani

Keyword(s):

Electroconvulsive Therapy ◽

Psychotic Disorders ◽

Tertiary Care ◽

International Classification Of Diseases ◽

Yield Response ◽

Psychiatric Diagnoses ◽

Care Hospital ◽

Dose Requirement ◽

Related Data ◽

And Gender

ABSTRACTContext: There is a paucity of systematic data reflecting the practice of electroconvulsive therapy (ECT) from developing countries. Aim: We aimed to identify the number of ECT sessions required to yield response and gender differences in the number of sessions across various diagnostic categories. Setting and Design: A record-based study from a teaching cum tertiary care hospital in South India. Subjects and Methods: Case records of patients who received modified ECT from January 2011 to January 2016 were reviewed. The sociodemographic details and ECT-related data were collected. Psychiatric diagnoses were ascertained as per the International Classification of Diseases, 10th Revision criteria. Statistical Analysis Used: Kruskal–Wallis test and Mann–Whitney U-test. Results: Among 148 patients, 82 (55.4%) had mood disorder (bipolar disorder and recurrent depressive disorder), 43 (29.1%) had schizophrenia, and 22 (14.9%) had other acute and transient psychotic disorders (ATPDs). Patients with mood disorders, schizophrenia, and other ATPD received 7.3 (± 3.8), 9.7 (± 6.1), and 5.4 (± 2.0) ECT sessions, respectively, to achieve response. There was no gender difference in the number of sessions received. Conclusion: Our findings show that number of ECT sessions required to yield response may be disorder-specific. Gender does not influence the ECT dose requirement. Variations in ECT parameters across settings may limit the generalizability of results.

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Propofol and Methohexital as Anesthetic Agents for Electroconvulsive Therapy

Journal of Ect ◽

10.1097/0b013e31814da971 ◽

2007 ◽

Vol 23 (4) ◽

pp. 239-243 ◽

Cited By ~ 41

Author(s):

Christian Geretsegger ◽

Marius Nickel ◽

Berthold Judendorfer ◽

Erika Rochowanski ◽

Erich Novak ◽

...

Keyword(s):

Electroconvulsive Therapy ◽

Anesthetic Agents

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Particularities of Nursing in Electroconvulsive Therapy

Acta Medica Transilvanica ◽

10.2478/amtsb-2019-0019 ◽

2019 ◽

Vol 24 (4) ◽

pp. 62-64

Author(s):

Diana Vulea ◽

Ciprian Băcilă

Keyword(s):

Electroconvulsive Therapy ◽

Professional Training ◽

Psychotic Disorders ◽

Therapeutic Process ◽

Medical Community ◽

Interpersonal Contact ◽

Proven Efficacy ◽

Controversial Topic ◽

Essential Contribution ◽

Depressive Episodes

Abstract Electroconvulsive therapy (ECT) has been a controversial topic, both in the general population and in the medical community since its initial implementation in 1938. Despite clinical applications and proven efficacy in psychiatric and neurological pathologies, such as schizophrenia, catatonia, psychotic disorders, depressive episodes, Parkinson’s disease and psychiatric pathological conditions that occurr during pregnancy or childbed, reluctance to apply ECT persists due to the low degree of information and professional training. The purpose of this article is to emphasize the importance of informing the medical team of the specific training in the provision of adequate nursing within the electroconvulsive therapy. These premises make an essential contribution to the smooth running of the therapeutic process. Taking into account the close interpersonal contact that the medical nurses have with the patient through the profession specifics, it is the appropriate framework to inform the patient and the family regarding the need to establish electroconvulsive therapy, the risks, but especially its benefits. In conclusion, there is a need to establish training courses for nurses so as to ensure the functioning of the therapeutic team as a unit.

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Electroconvulsive therapy (ECT) treatments in late-onset schizophrenia: Report of a case

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2053 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S556-S556

Author(s):

M. Valverde Barea ◽

F. Cartas Moreno ◽

M.E. Ortigosa Luque

Keyword(s):

Behavioral Disorders ◽

Electroconvulsive Therapy ◽

Psychotic Disorders ◽

Late Onset ◽

Personal History ◽

Psychotic Symptoms ◽

Sexual Content ◽

History Of ◽

Competing Interest ◽

Effective Result

Female patient, 66 years old, who goes to the doctor because of behavioral disorders and delusional injury 8 months of evolution. She showed no personal history of psychiatric disorders. In the psychopathological examination some relevant symptoms are seen delusions of prejudice with their immediate surroundings, self-referential regarding neighbors and walls. Delusional interpretations of sexual content. Punitive pseudo hallucinations hearing which are identifies with her daughters and sex with her son-in-law. Behavioral disorders consisting of going out naked into the street overnight and rebuking pedestrians; furthermore, she showed heteroaggressivity towards objects. Logical psychotropic treatment is initiated as indicated by the guidelines having no effect. Electroconvulsive therapy being tested an effective result. The late-onset schizophrenia symptoms should be taken into account in people with psychotic symptoms start at an advanced age, but is most prevalent at younger ages. Electroconvulsive therapy (ECT) may be used as an adjunct to drug therapy or as second-line treatment in patients with affective or psychotic disorders resistant to treatment with psychotropic drugs. It is essential a differential diagnosis with dementia symptoms previously established, given that part of the late-onset schizophrenia evolves to dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A Retrospective Comparison of Anesthetic Agents in Electroconvulsive Therapy

Journal of Ect ◽

10.1097/01.yct.0000244238.17791.a4 ◽

2006 ◽

Vol 22 (4) ◽

pp. 243-246 ◽

Cited By ~ 9

Author(s):

Jennifer C. Swaim ◽

Maher Mansour ◽

Salina M. Wydo ◽

Jeffrey L. Moore

Keyword(s):

Electroconvulsive Therapy ◽

Anesthetic Agents ◽

Retrospective Comparison

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