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By Brian Still Physician
David Michael Semple, William Gunn, Zoe Davidson, Filippo Queirazza
OBJECTIVES: Following on from our previous work looking at the interrater reliability of assessing seizure adequacy for electroconvulsive therapy (ECT), we sought to examine whether a specific teaching module could improve the reliability of visual inspection of electroencephalography (EEG) recordings for specific features of seizure length, presence of polyspike, δ wave activity, and post-ictal suppression. METHODS: Twelve medical practitioners at varying levels of training and ECT experience rated 15 EEG traces after minimal training and a further set of 15 EEG traces after a more detailed training...
September 2014: Journal of ECT
Willemijn T Heijnen, Tom K Birkenhäger, André I Wierdsma, Walter W van den Broek
Failure to respond to antidepressants probably is the most common indication for electroconvulsive therapy (ECT). The literature seems to be divided as to whether medication resistance has a negative influence on the efficacy of subsequent ECT. Therefore, we performed a systematic review to investigate the effect of previous pharmacotherapy failure on the efficacy of ECT. Relevant cohort studies were identified from systematic search of the PubMed electronic database. Seven studies were included in this meta-analysis: the overall remission rate amounts to 48...
October 2010: Journal of Clinical Psychopharmacology
Mustafa M Husain, A John Rush, Max Fink, Rebecca Knapp, Georgios Petrides, Teresa Rummans, Melanie M Biggs, Kevin O'Connor, Keith Rasmussen, Marc Litle, Wenle Zhao, Hilary J Bernstein, Glenn Smith, Martina Mueller, Shawn M McClintock, Samuel H Bailine, Charles H Kellner
BACKGROUND: Remission of illness in patients with major depressive disorder (MDD) is achieved in less than half of patients initially treated with medication. Electroconvulsive therapy (ECT) is another treatment option. We report the speed of response and remission rates in a cohort of depressed patients who received a course of acute-phase ECT in the initial phase of an ongoing multicenter randomized trial of continuation ECT versus pharmacotherapy. METHOD: Patients with MDD according to DSM-IV criteria received bilateral ECT 3 times weekly...
April 2004: Journal of Clinical Psychiatry
Tom G Bolwig
This article reviews 3 current theories of electroconvulsive therapy (ECT). One theory points to generalized seizures as essential for the therapeutic efficacy of ECT. Another theory highlights the normalization of neuroendocrine dysfunction in melancholic depression as a result of ECT. A third theory is based on recent findings of increased hippocampal neurogenesis and synaptogenesis in experimental animals given electroconvulsive seizures. Presently, the endocrine theory has the strongest foundation to explain the working mechanism of ECT...
January 2011: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Pascal Sienaert
In this narrative review, the current knowledge base on the efficacy and the practice of electroconvulsive therapy (ECT) is reviewed, and its relevance for the practising psychiatrist is appreciated. In the past decade, several large-scale studies have confirmed the significant superiority of ECT in the treatment of severe and refractory psychiatric conditions, such as major depressive disorder and bipolar disorder. However, the efficacy of ECT is not reflected in current treatment algorithms, where ECT is often reserved as a last resort...
January 2011: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Olli Kampman, Esa Leinonen
No abstract text is available yet for this article.
September 2013: Pharmacogenomics
Varuni A de Silva, Wickramaarachchige D Lakmini, Heshan N Gunawardena, Raveen Hanwella
INTRODUCTION: In the International Statistical Classification of Diseases and Related Health Problems 10 and Diagnostic and Statistical Manual of Mental Disorders IV classification systems, catatonia is classified as a subtype of schizophrenia. However, catatonia is more frequently associated with mood disorders than schizophrenia. It is also associated with organic conditions. Catatonia responds to treatment with benzodiazepines and electroconvulsive therapy rather than antipsychotics...
August 23, 2013: Journal of Medical Case Reports
Joan Prudic, Roger F Haskett, W Vaughn McCall, Keith Isenberg, Thomas Cooper, Peter B Rosenquist, Benoit H Mulsant, Harold A Sackeim
OBJECTIVE: To determine whether starting antidepressant medication at the start of electroconvulsive therapy (ECT) reduces post-ECT relapse and to determine whether continuation pharmacotherapy with nortriptyline (NT) and lithium (Li) differs in efficacy or adverse effects from continuation pharmacotherapy with venlafaxine (VEN) and Li. METHODS: During an acute ECT phase, 319 patients were randomized to treatment with moderate dosage bilateral ECT or high-dosage right unilateral ECT...
March 2013: Journal of ECT
Harold A Sackeim, Joan Prudic, Mitchell S Nobler, Linda Fitzsimons, Sarah H Lisanby, Nancy Payne, Robert M Berman, Eva-Lotta Brakemeier, Tarique Perera, D P Devanand
BACKGROUND: While electroconvulsive therapy (ECT) in major depression is effective, cognitive effects limit its use. Reducing the width of the electrical pulse and using the right unilateral electrode placement may decrease adverse cognitive effects, while preserving efficacy. METHODS: In a double-masked study, we randomly assigned 90 depressed patients to right unilateral ECT at 6 times seizure threshold or bilateral ECT at 2.5 times seizure threshold, using either a traditional brief pulse (1...
April 2008: Brain Stimulation
Harold A Sackeim, Elaine M Dillingham, Joan Prudic, Thomas Cooper, W Vaughn McCall, Peter Rosenquist, Keith Isenberg, Keith Garcia, Benoit H Mulsant, Roger F Haskett
CONTEXT: Medication resistance is the leading indication for use of electroconvulsive therapy (ECT) in major depression. The practice of stopping antidepressant medications prior to ECT derived from studies in the 1960s and 1970s in nonresistant samples. There is also continuing controversy regarding the relative efficacy and adverse effects of right unilateral and bilateral ECT. OBJECTIVE: To test the hypotheses that, compared with placebo, concomitant treatment with nortriptline or venlafaxine during the ECT course enhances short-term efficacy without a meaningful effect on adverse effects and reduces the rate of post-ECT relapse, and to test the hypotheses that high-dose, right-sided, unilateral ECT is equivalent in efficacy to moderate-dosage bilateral ECT and retains advantages with respect to cognitive adverse effects...
July 2009: Archives of General Psychiatry
H A Sackeim, R F Haskett, B H Mulsant, M E Thase, J J Mann, H M Pettinati, R M Greenberg, R R Crowe, T B Cooper, J Prudic
CONTEXT: Electroconvulsive therapy (ECT) is highly effective for treatment of major depression, but naturalistic studies show a high rate of relapse after discontinuation of ECT. OBJECTIVE: To determine the efficacy of continuation pharmacotherapy with nortriptyline hydrochloride or combination nortriptyline and lithium carbonate in preventing post-ECT relapse. DESIGN: Randomized, double-blind, placebo-controlled trial conducted from 1993 to 1998, stratified by medication resistance or presence of psychotic depression in the index episode...
March 14, 2001: JAMA: the Journal of the American Medical Association
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