scholarly journals Anaesthesia for electroconvulsive therapy: a role for etomidate

2002 ◽  
Vol 26 (9) ◽  
pp. 351-353 ◽  
Author(s):  
Susan M. Benbow ◽  
Priti Shah ◽  
Joe Crentsil
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Cardiac Disease ◽  
Maximum Level ◽  
Electrical Stimulus ◽  
Induction Agent ◽  
Clinical Implications ◽  
Anaesthetic Drug ◽  
The Individual ◽  
Severe Cardiac Disease

Aims and MethodThree cases are described to illustrate the elective use of etomidate in electroconvulsive therapy (ECT) anaesthesia.ResultsUse of etomidate is described in an individual who was treated with an electrical stimulus at the maximum level for the ECT machine in use; in a person who had severe side-effects with an alternative induction agent; and in a person with severe cardiac disease.Clinical ImplicationsThe anaesthetic drug should be tailored to the individual needs of the person being treated with ECT. Clinics should involve local anaesthetic departments in reviewing their anaesthetic practice.

scholarly journals Subjective experience of electroconvulsive therapy

2004 ◽  
Vol 28 (8) ◽  
pp. 289-291 ◽  
Author(s):  
Susan M. Benbow ◽  
Joe Crentsil
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Side Effect ◽  
Subjective Experience ◽  
Treatment Plan ◽  
Clinical Implications ◽  
Policies And Procedures ◽  
Routine Monitoring

Aims and MethodPeople receiving electroconvulsive therapy (ECT) in one clinic completed side-effect rating questionnaires during treatment, and a questionnaire rating their experience of different aspects of treatment on completion of the treatment course.ResultsSide-effects were commonly reported, but predominantly rated as mild or moderate. Most people reported that ECT had made them a little or a lot better, and that the treatment had been fairly or very well explained. Fewer than a fifth of respondents rated ECT as slightly or much worse than going to the dentist.Clinical ImplicationsWe recommend routine monitoring of the subjective experience of ECT, during treatment and on completion of the course. Ratings should inform the treatment plan, the policies and procedures of the ECT clinic.

New Developments in Electroconvulsive Therapy and Magnetic Seizure Therapy

CNS Spectrums ◽  
2003 ◽  
Vol 8 (7) ◽  
pp. 529-536 ◽  
Author(s):  
Sarah H. Lisanby ◽  
Oscar Morales ◽  
Nancy Payne ◽  
Edward Kwon ◽  
Linda Fitzsimons ◽  
...  
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Early Stage ◽  
Electrical Stimulus ◽  
Treatment Technique ◽  
Clinical Value ◽  
Convulsive Therapy ◽  
Magnetic Seizure Therapy ◽  
Stage Of Development ◽  
New Findings

ABSTRACTNew findings regarding the mechanisms of action of electroconvulsive therapy (ECT) have led to novel developments in treatment technique to further improve this highly effective treatment for major depression. These new approaches include novel electrode placements, optimization of electrical stimulus parameters, and new methods for inducing more targeted seizures (eg, magnetic seizure therapy [MST]). MST is the use of transcranial magnetic stimulation to induce a seizure. Magnetic fields pass through tissue unimpeded, providing more control over the site and extent of stimulation than can be achieved with ECT. This enhanced control represents a means of focusing the treatment on target cortical structures thought to be essential to antidepressant response and reducing spread to medial temporal regions implicated in the cognitive side effects of ECT. MST is at an early stage of development. Preliminary results suggest that MST may have some advantages over ECT in terms of subjective side effects and acute cognitive functioning. Studies designed to address the antidepressant efficacy of MST are underway. As with all attempts to improve convulsive therapy technique, the clinical value of MST will need to be established through controlled clinical trials. This article reviews the experience to date with MST, and places this work in the broader context of other means of optimizing convulsive therapy in the treatment of depression.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

Protecting privacy to protect mental health: the new ethical imperative

2019 ◽  
Vol 45 (9) ◽  
pp. 604-607 ◽  
Author(s):  
Elias Aboujaoude
Keyword(s):  
Mental Health ◽  
Electronic Medical Records ◽  
Psychological Health ◽  
Medical Records ◽  
Personal Data ◽  
Psychological Development ◽  
Clinical Implications ◽  
Patient Relationship ◽  
Ethical Imperative ◽  
The Individual

Confidentiality is a central bioethical principle governing the provider–patient relationship. Dating back to Hippocrates, new laws have interpreted it for the age of precision medicine and electronic medical records. This is where the discussion of privacy and technology often ends in the scientific health literature when Internet-related technologies have made privacy a much more complex challenge with broad psychological and clinical implications. Beyond the recognised moral duty to protect patients’ health information, clinicians should now advocate a basic right to privacy as a means to safeguard psychological health. The article reviews empirical research into the functions of privacy, the implications for psychological development and the resigned sentiment taking hold regarding the ability to control personal data. The article concludes with a call for legislative, educational and research steps to readjust the equilibrium between the individual and ‘Big Data’.

Propofol Anaesthesia in Electroconvulsive Therapy

1994 ◽  
Vol 165 (4) ◽  
pp. 506-509 ◽  
Author(s):  
Christopher F. Fear ◽  
Carl S. Littlejohns ◽  
Eryl Rouse ◽  
Paul McQuail
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Induction Agent ◽  
Double Blind Study ◽  
Major Depressive ◽  
Seizure Duration ◽  
Double Blind ◽  
Induction Agents

BackgroundThe induction agent propofol is known to reduce electroconvulsive therapy (ECT) seizure duration. It is assumed that outcome from depression is adversely affected by this agent. This study compares propofol and methohexitone as induction agents for ECT.MethodIn a prospective, randomised, double-blind study 20 subjects with major depressive disorder (DSM-III-R criteria) received propofol or methohexitone anaesthesia. The Hamilton Depression Rating Scale and Beck Depression Inventory were used to assess depression before therapy, at every third treatment, and at the end of therapy. Seizure duration was measured using the cuff technique.ResultsMean seizure durations (P < 0.01) and mean total seizure duration (P < 0.01) were shorter in the propofol group. There was no difference in outcome.ConclusionsUse of propofol may not adversely affect outcome from depression and it is not necessarily contraindicated as an induction agent for ECT. Our results should be interpreted cautiously, and larger studies are needed.

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