scholarly journals Speed of electroconvulsive therapy for depression: Effects of electrode placement

2021 ◽  
Vol 143 (5) ◽  
pp. 444-452
Author(s):  
Celine A. Fox ◽  
Declan M. McLoughlin
Keyword(s):  
Electroconvulsive Therapy ◽  
Electrode Placement

scholarly journals Alfentanil anesthetic augmentation lengthens seizure duration in electroconvulsive therapy with older people

2016 ◽  
Vol 28 (6) ◽  
pp. 1051-1052
Author(s):  
Craig D'Cunha ◽  
Christos Plakiotis ◽  
Daniel W. O'Connor
Keyword(s):  
Side Effects ◽  
Older People ◽  
Electroconvulsive Therapy ◽  
Electrode Placement ◽  
Seizure Threshold ◽  
Dose Titration ◽  
Seizure Duration ◽  
New Learning ◽  
Prescription Rates ◽  
Cognitive Side Effects

Electroconvulsive therapy (ECT) prescription rates rise with age, making it important that treatments be made as effective and safe as possible (Plakiotis et al., 2012). Older people are vulnerable to post-treatment confusion and to subsequent deficits in attention, new learning, and autobiographical memory (Gardner and O'Connor, 2008). Strategies to minimize cognitive side-effects include unilateral electrode placement and stimulus dose titration whereby electrical charge is individually calibrated to seizure threshold (Sackeim et al., 2000). It remains the case, however, that threshold levels typically rise over the treatment course, leading to an increase both in delivered charge and the risk of adverse sequelae.

Electrode Placement, Stimulus Dosing and Seizure Monitoring during ECT

1994 ◽  
Vol 28 (4) ◽  
pp. 675-683 ◽  
Author(s):  
G. Murugesan
Keyword(s):  
Cognitive Impairment ◽  
Electroconvulsive Therapy ◽  
Electrical Stimulus ◽  
Electrode Placement ◽  
Treatment Modalities ◽  
Points Of View ◽  
Bilateral Treatment

Electroconvulsive therapy is one of the most useful, safe and predictable treatment modalities in psychiatry. For optimal results proper application of the procedure is essential. Over the years the procedure has undergone considerable refinement, yet not all those who administer the treatment are fully conversant with this. This paper addresses issues relating to electrode placement, stimulus dosing and seizure monitoring from practical and clinical points of view. Right unilateral ECT, if administered with high electrical stimulus, produces results close to bilateral treatment with substantially less cognitive impairment. However, certain patients may only respond to bilateral ECT. Adequate training for clinicians administering ECT is recommended.

Electroconvulsive therapy

2020 ◽  
pp. 277-290
Author(s):  
Keith G. Rasmussen
Keyword(s):  
Electrical Stimulation ◽  
Electroconvulsive Therapy ◽  
Memory Impairment ◽  
Controlled Trial ◽  
Rapid Expansion ◽  
Electrode Placement ◽  
Effective Treatment Modality ◽  
The World ◽  
Technical Modifications ◽  
History Of

This chapter on electroconvulsive therapy (ECT) surveys the history of this effective treatment modality in psychiatry. It reviews the first publication introducing ECT, which was followed by rapid expansion throughout the world. Next, the important topic of memory impairment is reviewed. Thereafter, it discusses the technical modifications that resulted in less memory impairment, most notably unilateral electrode placement and brief-pulse square-wave electrical stimulation. The publication of a placebo-controlled trial establishing efficacy using modern research methods is also discussed. Finally, a controlled trial of continuation ECT is presented, which touches on the need to prevent relapse. The chapter can be appreciated by readers of any background, whether medical or not.

Electrode placement in ECT: cognitive effects

1990 ◽  
Vol 20 (2) ◽  
pp. 335-344 ◽  
Author(s):  
J. S. Lawson ◽  
James Inglis ◽  
N. J. Delva ◽  
Martin Rodenburg ◽  
J. J. Waldron ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Cognitive Status ◽  
Clinical Depression ◽  
Electrode Placement ◽  
Cognitive Effects ◽  
Major Depressive ◽  
Differential Effects

SynopsisForty patients suffering from a major depressive disorder, for whom electroconvulsive therapy (ECT) was clinically indicated, were assigned to one of three electrode placement groups: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparisons of these groups in terms of cognitive status showed that the BF placement, which avoided both temporal regions, spared both verbal and nonverbal functions. These differential effects, which were independent of the degree of clinical depression, were not, however, evident three months after the last ECT.

Changing Patterns of Electroconvulsive Therapy Use: Results of a Five-Year Survey

1991 ◽  
Vol 25 (4) ◽  
pp. 535-540 ◽  
Author(s):  
Cherrie A. Galletly ◽  
Colin D. Field ◽  
Cheryl L. Ormond
Keyword(s):  
Informed Consent ◽  
Electroconvulsive Therapy ◽  
Electrode Placement ◽  
Seizure Threshold ◽  
Efficacy And Safety ◽  
Gradual Decline ◽  
Proven Efficacy ◽  
Schizophrenic Patients ◽  
Changing Patterns ◽  
Medicolegal Issues

Despite its proven efficacy and safety, electroconvulsive therapy (ECT) continues to be a controversial treatment. Ongoing scrutiny is therefore particularly important. We reviewed 315 patients who received 3903 ECT treatments over a five year period, and found a gradual decline in the use of ECT, due mainly to a reduction in ECT for schizophrenic patients. Eighty percent of treatments were given with bilateral electrode placement, although we did find the incidence of adverse effects to be greater with bilateral ECT. Most patients concurrently received medications which raise the seizure threshold. The administration of ECT to patients unable or unwilling to give informed consent raises ethical and medicolegal issues. We found that such difficulties had arisen with at least 16% of patients.

The Role of Electroconvulsive Therapy in the Treatment of Depressive Illness in Old Age

1989 ◽  
Vol 155 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Susan M. Benbow
Keyword(s):  
Old Age ◽  
Electroconvulsive Therapy ◽  
Age Groups ◽  
The Elderly ◽  
Depressive Illness ◽  
Electrode Placement ◽  
Physical Problems ◽  
Younger Age ◽  
Old Age Psychiatry ◽  
Temporary Memory

Electroconvulsive therapy is an important treatment in the depressive states of late life, and there is general agreement about the indications for its use in old age psychiatry. Indeed, old age may be associated with a better response to ECT than that in younger age groups. The additional risk involved through physical problems in the elderly is not great when compared with that of continuing depression and of the side-effects of alternative treatments. Temporary memory disorders and confusion may occur, but are minimised if unilateral electrode placement is used. Some patients treated with unilateral ECT do not respond, but will respond to bilateral treatment. Anxiety over unwanted treatment effects, which can lead to ineffective treatment of depressive illness, must be outweighed by knowledge of the dangers of leaving depression untreated in old age.

scholarly journals Electroconvulsive therapy for negative symptoms in schizophrenia: a literature review from 2000 to 2021

2021 ◽  
Author(s):  
Marco M. Zierhut ◽  
Renaldo M. Bernard ◽  
Eleanor Turner ◽  
Sara Mohamad ◽  
Eric Hahn ◽  
...  
Keyword(s):  
Literature Review ◽  
Electroconvulsive Therapy ◽  
Negative Symptoms ◽  
Assessment Tool ◽  
Case Reports ◽  
Electrode Placement ◽  
Future Research ◽  
Psychotherapeutic Treatment ◽  
Clinical Challenge ◽  
Study Designs

AbstractNegative symptoms in schizophrenia remain a clinical challenge with small effect sizes and evidence for pharmacological or psychotherapeutic treatment approaches. Studies suggest that electroconvulsive therapy (ECT) holds some promise as a treatment option of often persistent negative symptoms with clinically meaningful effects. This review summarizes the existing evidence on the efficacy of ECT on negative symptoms in patients with schizophrenia. Thirty-five publications were included in this literature review comprising 21 studies, two meta-analyses, eight reviews and four case reports. Conclusions should be interpreted cautiously, given the small number and methodological shortcomings of the included publications with a variation of study designs and missing standardized protocols. Implications for future research and practice are critically discussed. Recommendations are given to provide more evidence that will meet the clinical challenge of reducing the negative symptoms in schizophrenia. Study designs that focus explicitly on negative symptoms and assess patients over longer follow up periods could be helpful. Future research should include control groups, and possibly establish international multicentered studies to get a sufficient study population. Findings suggest that patients with schizophrenia resistant to pharmacological treatment might benefit from ECT. A risk and benefit assessment speaks in favour of the ECT treatment. Future practice of ECT should include a combination treatment with antipsychotics. Whereas the use of anaesthetics and electrode placement does not seem to play a role, the recommendation regarding frequency of ECT treatments is currently three times a week, For the assessment of negative symptoms the assessment tool should be chosen carefully.

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