Cognitive effects of brief and ultrabrief pulse bitemporal electroconvulsive therapy: a randomised controlled proof-of-concept trial

AbstractBackgroundReduction of the pulse width has been reported to improve ECT outcomes with unilateral ECT (similar efficacy, fewer cognitive side effects), but has been minimally studied for bitemporal ECT. The only study comparing brief and ultrabrief pulse bitemporal ECT found reduced efficacy for bitemporal ultrabrief compared to bitemporal brief pulse stimulation. This randomised controlled trial (RCT) aimed to test if ultrabrief pulse bitemporal ECT results in fewer cognitive side effects than brief pulse bitemporal ECT, when given at doses adjusted with the aim of achieving comparable efficacy.MethodsThirty-six participants were randomly assigned to receive ultrabrief (at 3 times seizure threshold) or brief (at 1.5 times seizure threshold) pulse bitemporal ECT given 3 times a week in a double-blind, controlled proof-of-concept trial. Blinded raters assessed mood and cognitive functioning over the ECT course.ResultsEfficacy and cognitive outcomes did not differ significantly between the two treatment groups over the ECT course. The ultrabrief pulse group performed better on a test of visual memory assessed acutely after an ECT treatment.ConclusionsThis study suggests there may be a small cognitive advantage in giving bitemporal ECT with an ultrabrief pulse when dosage is increased to match the efficacy of brief pulse bitemporal ECT, but the study was underpowered to fully examine this issue.Clinical Trials Registration: www.clinicaltrials.gov, NCT00870805.

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Comparison of the efficacy of oral oxycodone and oral codeine in the treatment of post-craniotomy pain – a randomized, double-blind trial

10.21203/rs.2.15934/v1 ◽

2019 ◽

Author(s):

Rui Min Lee ◽

Beatrice Chin Ling Lim ◽

Chin Ted Chong ◽

Mandy Pei-Pei Lim

Keyword(s):

Side Effects ◽

Analogue Scale ◽

Controlled Trial ◽

Similar Efficacy ◽

Control Group ◽

Double Blind Trial ◽

Double Blind ◽

Scale Scores ◽

Double Blinded ◽

Experimental Group

Abstract Background Post-craniotomy pain has been reported to be moderate to severe. Management of post-craniotomy pain is often inadequate, yet limited by the side effects of opioids. We aim to find out the efficacy of oral oxycodone as compared to oral codeine for the treatment of post-craniotomy pain in our institution.Methods A randomized, double blinded controlled trial was used to evaluate the efficacy of oral oxycodone versus oral codeine. 40 patients were randomized to the control group of codeine (n = 20) or the experimental group receiving oxycodone (n = 20) in addition to regular oral paracetamol for both groups of patients.Results There was no difference in the visual analogue scale scores at 24 hours (2.78 versus 1.85, p = 0.11) or side effects in the oxycodone group compared with the codeine group.Conclusions Oral oxycodone had similar efficacy as oral codeine in the management of post-craniotomy pain.

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A Double Blind Randomised Clinical Trial to Prevent Serious Side Effects of Dexamethasone during Pediatric Acute Lymphoblastic Leukemia Treatment

Blood ◽

10.1182/blood.v126.23.2495.2495 ◽

2015 ◽

Vol 126 (23) ◽

pp. 2495-2495 ◽

Cited By ~ 3

Author(s):

Lidewij T Warris ◽

Marry M van den Heuvel-Eibrink ◽

Femke K Aarsen ◽

Saskia MF Pluijm ◽

Marc B Bierings ◽

...

Keyword(s):

Circadian Rhythm ◽

Side Effects ◽

Lymphoblastic Leukemia ◽

Controlled Trial ◽

Dexamethasone Treatment ◽

Double Blind ◽

Pediatric Acute Lymphoblastic Leukemia ◽

Sleeping Problems ◽

Physiological Dose ◽

Randomised Controlled

Abstract Background/Objectives: Dexamethasone is highly effective in the treatment of pediatric acute lymphoblastic leukemia (ALL), but can induce serious metabolic and neuropsychological side effects. Recent studies have led to the hypothesis that neuropsychological side effects could be due to cortisol depletion of the cerebral mineralocorticoid receptor. We therefore studied whether adding a physiological dose of hydrocortisone to dexamethasone treatment reduces neuropsychological and metabolic side effects in children with ALL. Design/Methods: We performed a multicentre double-blind, randomised controlled trial with a crossover design. Patients (3-16 years) treated with dexamethasone pulses according to the DCOG ALL protocols were included. Patients received hydrocortisone 10 mg/m2/day in a circadian rhythm during one dexamethasone course and placebo during another dexamethasone course in a randomised order. The primary outcome measures were mood and behavior (parent-reported Strenght and Difficulties Questionnaire- Dut (SDQ)). Secondary outcome measures included sleep (Sleep Disturbance Scale for Children (SDSC)), neurocognitive function, and metabolic parameters. Results: 50 subjects were enrolled, of which 48 patients completed both courses. For the total group no significant effects were found. However, in the subgroup of children with clinically significant behavioral side effects, adding hydrocortisone resulted in a significant reduction of side effects on overall stress (-4.9 (=0.9 SD), P =0.00), mood (-1.8 (=0.9 SD), P =0.03), behavior (-1.0 (=0.7 SD), P =0.01), and impact (P <0.05). The subgroup with dexamethasone-related sleeping problems did benefit on total sleeping problems (-4.3, P< 0.05). In contrast, hydrocortisone addition did not affect metabolic parameters. Conclusion: This randomised controlled trial provides evidence that addition of a physiological dose of hydrocortisone in circadian rhythm during dexamethasone treatment in pediatric ALL patients reduces side effects on behavior, mood and sleep. This novel and simple intervention may be valuable for all patients on high-dose dexamethasone treatment. Disclosures No relevant conflicts of interest to declare.

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Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): A short-term randomised controlled trial in pharmaco-resistant major depression

Journal of Affective Disorders ◽

10.1016/j.jad.2006.11.012 ◽

2007 ◽

Vol 101 (1-3) ◽

pp. 149-157 ◽

Cited By ~ 35

Author(s):

Gerhard W. Eschweiler ◽

Reinhard Vonthein ◽

Ruediger Bode ◽

Michael Huell ◽

Andreas Conca ◽

...

Keyword(s):

Side Effects ◽

Major Depression ◽

Randomised Controlled Trial ◽

Clinical Efficacy ◽

Electroconvulsive Therapy ◽

Controlled Trial ◽

Short Term ◽

Randomised Controlled ◽

Cognitive Side Effects

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Pain Relief in labour: A randomized controlled trial comparing pentazocine with Tramadol

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v3i1.1433 ◽

1970 ◽

Vol 3 (1) ◽

pp. 14-18 ◽

Cited By ~ 3

Author(s):

O Kuti ◽

AF Faponle ◽

AB Adeyemi ◽

AT Owolabi

Keyword(s):

Side Effects ◽

Pain Relief ◽

Drug Administration ◽

Controlled Trial ◽

Analgesic Efficacy ◽

Labour Pain ◽

Double Blind ◽

Active Labour ◽

Good Pain Relief ◽

Randomised Controlled

Aim: To assess and compare the analgesic efficacy and side effects of Pentazocine and Tramadol. Method: This double blind randomised controlled trial was carried out at the labour ward of Wesley Guild Hospital Ilesa Nigeria. One hundred normal pregnant women in active labour at term were randomly assigned to receive either intramuscular Pentazocine 30mg or intramuscular tramadol 100mg, at request for analgesia. Analgesic efficacy was assessed by verbal scales of pain intensity and relief; maternal and neonatal side effects were determined. Results: At 60 minutes after drug administration 47.7% and 30.9% of women, in the pentazocine and tramadol group respectively, experienced moderate to good pain relief. Significantly more women in the pentazocine group (34.1%) than in the tramadol group(14.3%) rated their pain as mild (P < 0.05) sixty minutes after drug administration. Mean time to first subsequent request for analgesia was greater in the pentazocine group (181 minutes vs 113 minutes; P < 0.05). There was no significant differences between the drugs in maternal side effects, labour and neonatal outcomes. Conclusion: Pentazocine provides better pain relief than tramadol in labor. Key words: Labour pain, pentazocine, tramadol doi:10.3126/njog.v3i1.1433NJOG 2008 May-June; 3(1): 14 - 18

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