Recurrence of depressive episodes after electroconvulsive therapy A retrospective comparison of inpatients treated in 1941-50 and 1974-83

1993 ◽  
Vol 47 (5) ◽  
pp. 361-368 ◽  
Author(s):  
Svend Otto Frederiksen ◽  
Giacomo Delia ◽  
Lars-Hakan Thorell ◽  
Michael Nilsson
Keyword(s):  
Electroconvulsive Therapy ◽  
Retrospective Comparison ◽  
Depressive Episodes

Augmentation of Valproate with Lithium in a Case of Rapid Cycling Affective Disorder*

1992 ◽  
Vol 37 (8) ◽  
pp. 584-585 ◽  
Author(s):  
Verinder Sharma ◽  
Emmanuel Persad
Keyword(s):  
Valproic Acid ◽  
Affective Disorder ◽  
Electroconvulsive Therapy ◽  
Successful Treatment ◽  
Lithium Carbonate ◽  
Rapid Cycling ◽  
Depressive Episodes

Rapid cycling affective disorder is characteristically unresponsive to conventional interventions. In bipolar rapid cycling affective disorder, the manic episodes may be controlled with either neuroleptics or electroconvulsive therapy, but the depressive episodes are highly intractable. This report describes the successful treatment of a patient with a bipolar rapid cycling affective disorder using a combination of valproic acid and lithium carbonate.

scholarly journals Magnetic Resonance Spectroscopy in Depressed Subjects Treated With Electroconvulsive Therapy—A Systematic Review of Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Vera Jane Erchinger ◽  
Lars Ersland ◽  
Stein Magnus Aukland ◽  
Christopher C. Abbott ◽  
Leif Oltedal
Keyword(s):  
Systematic Review ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Electroconvulsive Therapy ◽  
Resonance Spectroscopy ◽  
Gamma Aminobutyric Acid ◽  
Number Of Patients ◽  
Neurochemical Changes ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Electroconvulsive therapy (ECT) is considered to be the most effective acute treatment for otherwise treatment resistant major depressive episodes, and has been used for over 80 years. Still, the underlying mechanism of action is largely unknow. Several studies suggest that ECT affects the cerebral neurotransmitters, such as gamma-aminobutyric acid (GABA) and glutamate. Magnetic resonance spectroscopy (MRS) allows investigators to study neurotransmitters in vivo, and has been used to study neurochemical changes in the brain of patients treated with ECT. Several investigations have been performed on ECT-patients; however, no systematic review has yet summarized these findings. A systematic literature search based on the Prisma guidelines was performed. PubMed (Medline) was used in order to find investigations studying patients that had been treated with ECT and had undergone an MRS examination. A search in the databases Embase, PsycInfo, and Web of Science was also performed, leading to no additional records. A total of 30 records were identified and screened which resulted in 16 original investigations for review. The total number of patients that was included in these studies, ignoring potential overlap of samples in some investigations, was 325. The metabolites reported were N-acetyl aspartate, Choline, Myoinositol, Glutamate and Glutamine, GABA and Creatine. The strongest evidence for neurochemical change related to ECT, was found for N-acetyl aspartate (reduction), which is a marker of neuronal integrity. Increased choline and glutamate following treatment was also commonly reported.

scholarly journals Particularities of Nursing in Electroconvulsive Therapy

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.

scholarly journals Electroconvulsive therapy in the continuation and maintenance treatment of depression: Systematic review and meta-analyses

2017 ◽  
Vol 52 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Alby Elias ◽  
Vivek H Phutane ◽  
Sandy Clarke ◽  
Joan Prudic
Keyword(s):  
Confidence Interval ◽  
Electroconvulsive Therapy ◽  
Risk Ratio ◽  
Systematic Reviews ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Risk Of Bias ◽  
Meta Analyses ◽  
Depressive Episodes

Objective: Acute course of electroconvulsive therapy is effective in inducing remission from depression, but recurrence rate is unacceptably high following termination of electroconvulsive therapy despite continued pharmacotherapy. Continuation electroconvulsive therapy and maintenance electroconvulsive therapy have been studied for their efficacy in preventing relapse and recurrence of depression. The purpose of this meta-analysis was to examine the efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy in preventing relapse and recurrence of depression in comparison to antidepressant pharmacotherapy alone. Methods: We searched MEDLINE, Embase, PsycINFO, clinicaltrials.gov and Cochrane register of controlled trials from the database inception to December 2016 without restriction on language or publication status for randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. Two independent Cochrane reviewers extracted the data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses. The risk of bias was assessed using four domains of the Cochrane Collaboration Risk of Bias Tool. Outcomes were pooled using random effect model. The primary outcome was relapse or recurrence of depression. Results: Five studies involving 436 patients were included in the meta-analysis. Analysis of the pooled data showed that continuation electroconvulsive therapy and maintenance electroconvulsive therapy, both with pharmacotherapy, were associated with significantly fewer relapses and recurrences than pharmacotherapy alone at 6 months and 1 year after a successful acute course of electroconvulsive therapy (risk ratio = 0.64, 95% confidence interval = [0.41, 0.98], p = 0.04, risk ratio = 0.46, 95% confidence interval = [0.21, 0.98], p = 0.05, respectively). There was insufficient data to perform a meta-analysis of stand-alone continuation electroconvulsive therapy or maintenance electroconvulsive therapy beyond 1 year. Conclusion: There are only a few randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. The preliminary and limited evidence suggests the modest efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy with concomitant pharmacotherapy in preventing relapse and recurrence of depressive episodes for 1 year after the remission of index episode with the acute course of electroconvulsive therapy.

A Retrospective Comparison of Anesthetic Agents in Electroconvulsive Therapy

2006 ◽  
Vol 22 (4) ◽  
pp. 243-246 ◽  
Author(s):  
Jennifer C. Swaim ◽  
Maher Mansour ◽  
Salina M. Wydo ◽  
Jeffrey L. Moore
Keyword(s):  
Electroconvulsive Therapy ◽  
Anesthetic Agents ◽  
Retrospective Comparison

Electroconvulsive Therapy and Depression with Psychotic Symptoms: a Case Report

2011 ◽  
Vol 26 (S2) ◽  
pp. 1136-1136
Author(s):  
A. Castillo ◽  
M. Lloret ◽  
M. Harto ◽  
A. Tatay ◽  
C. Almonacid ◽  
...  
Keyword(s):  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Antipsychotic Agents ◽  
Pharmacological Therapy ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Psychotic Features ◽  
Depressive Episodes

IntroductionPsychotic symptoms in depression are indicators of severity and poor prognosis. It usually requires psychopharmacotherapy with antidepressants and antipsychotic agents and it may even require electroconvulsive therapy (ECT).Aims, methodologyTo review the indications of ECT in major depression through the study of a clinical case of a patient admitted in an indoor psychiatric unit.ResultsA 64-year-old woman diagnosed as bipolar affective disorder 20 years ago. Her first manic episode required hospitalization. Afterwards, she remained clinically stable for 18 years with pharmacotherapy with lithium. Lately she was admitted due to a major depressive episode with psychotic features (injury delusions, ruin and catastrophe). Antidepressant and antipsychotic treatment was added, improving her symptoms. However, she had to be readmitted two months later with severe psychotic symptoms that did not improve with pharmacological treatment. ECT was added to her treatment. She improved after a few sessions. During the last years, she has presented depressive episodes with psychotic symptoms at least once a year, and all of them have required ECT.ConclusionsECT is an alternative to pharmacological therapy in depression with psychotic symptoms in patients with no response to drugs. According to studies and clinical practice, ETC has been effective as we see in this case. Therefore, ECT is a technique to consider in major depression, not only in patients who do not respond to drug therapy but also in those who do not tolerate psychopharmacological, who suffer from severe or psychotic symptoms, suicide thoughts or those, psychomotor agitation or stupor.

Electroconvulsive therapy in the treatment of mixed states in bipolar disorder

2008 ◽  
Vol 23 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Marc Valentí ◽  
Antoni Benabarre ◽  
Margarita García-Amador ◽  
Oriol Molina ◽  
Miquel Bernardo ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Quality Criteria ◽  
Transcranial Stimulation ◽  
Review Of The Literature ◽  
Controlled Clinical Trials ◽  
Mixed States ◽  
Technical Developments ◽  
Depressive Episodes ◽  
Required Quality ◽  
Deep Brain

AbstractIntroductionMixed bipolar states are not infrequent and may be extremely difficult to treat. Lithium, anticonvulsants including valproate and carbamazepine, and antipsychotics such as olanzapine, ziprasidone, and aripiprazole have been reported to be at least partially effective in controlled clinical trials, but many patients do not respond to pharmacological approaches. Electroconvulsive therapy has been tested to be efficacious for the treatment of both manic and depressive episodes, but much less evidence is available with regards to mixed states. The aim of the review was to report the available evidence for the use of electroconvulsive therapy in mixed bipolar states.MethodsA systematic review of the literature on treatment of mixed states, focused on electroconvulsive therapy, was made, beginning in August 1992 and ending in March 2007. The key words were “electroconvulsive therapy” and “mixed bipolar”.ResultsOnly three studies met the required quality criteria and were included. This literature suggests that ECT is an effective, safe, and probably underutilized treatment of mixed states. Recent technical developments have made ECT more friendly, tolerable, and safe. Potential alternatives, such as vagus nerve stimulation, deep brain stimulation, or transcranial stimulation, are still far to be proved as effective as ECT.

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