15,918 results match your criteria Electroconvulsive Therapy


Autonomy and consent assessment for electroconvulsive therapy (ECT). A retrospective study of medical records.

Int J Law Psychiatry 2021 Jun 11;77:101716. Epub 2021 Jun 11.

University of Oslo, Faculty of Medicine, Centre for Medical Ethics, Oslo, Norway. Electronic address:

The Norwegian Mental Health Act allows involuntary treatment for patients who lack consent capacity, however it allows only administration of pharmaceutical treatment and nutrition and not ECT. In lack of specific regulations, the legal access to ECT without valid consent has been grounded on the general rule of necessity in the Norwegian Penal code. This restriction and lack of legal regulation has implications for patients' rights and legal security. Read More

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Changes in seizure duration during acute course electroconvulsive therapy.

Brain Stimul 2021 Jun 10. Epub 2021 Jun 10.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

Background: Seizure duration has long been measured as a potential marker of ECT treatment efficacy, with concern that short seizures may be clinically ineffective. Relatively small studies have documented a trend towards shorter seizures during acute course ECT, but data from large cohorts would help provide normative data on seizure duration changes during treatment.

Objective: This study analyzes the effects of age, sex, ECT dose, and treatment number on the duration of electrographic seizures during acute course ECT in a large single-center cohort. Read More

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Meta-analysis of brain structural changes after electroconvulsive therapy in depression.

Brain Stimul 2021 Jun 10. Epub 2021 Jun 10.

Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Austria. Electronic address:

Background: Increases in the volume of the amygdala and hippocampus after electroconvulsive therapy (ECT) are among the most robust effects known to the brain-imaging field. Recent advances in the segmentation of substructures of these regions allow for novel insights on the relationship between brain structure and clinical outcomes of ECT.

Objective: We aimed to provide a comprehensive synthesis of evidence available on changes in brain structure after ECT, including recently published data on hippocampal subfields. Read More

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Meta-analytic Evidence for Volume Increases in the Medial Temporal Lobe After Electroconvulsive Therapy.

Biol Psychiatry 2021 Jun 9. Epub 2021 Jun 9.

Department of Psychiatry, Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa; Department of Neuroscience and Pharmacology, University of Iowa, Iowa City, Iowa. Electronic address:

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Evaluation and treatment of older-age bipolar disorder: a narrative review.

Drugs Context 2021 27;10. Epub 2021 May 27.

Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, Buffalo NY, USA.

Objectives: This narrative review aims to synthesize information from the literature regarding older-age bipolar disorder (OABD) in order to provide up-to-date information on this important illness.

Methods: We searched Ovid (Medline, Embase and PsychInfo) on October 1, 2020, using the keywords "bipolar disorder", "older adults" and "elderly" to identify relevant articles on OABD. Additionally, the bibliography of identified articles was reviewed for pertinent studies. Read More

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A Novel Refractory Mood Disorders and Electroconvulsive Therapy Elective for Medical Students: Fighting Stigma through Experience.

Psychiatr Q 2021 Jun 7. Epub 2021 Jun 7.

McGovern Medical School at UTHealth, 6431 Fannin St, Houston, TX, 77030, USA.

Treatment resistant mood disorders (TRMD) have a significant impact on patients and society. Electroconvulsive therapy (ECT) has been shown to be effective for treatment resistant depression (TRD). Despite the effectiveness and safety of ECT, there remains significant stigma surrounding its use. Read More

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Lithium-Associated Hyperparathyroidism Followed by Catatonia.

AACE Clin Case Rep 2021 May-Jun;7(3):189-191. Epub 2020 Dec 19.

Valleywise Behavioral Health- Maryvale, 5102 W Campbell Ave, Phoenix, Arizona.

Objective: To familiarize the medical community with the less common adverse effects of lithium on parathyroid function, we present a case of lithium-associated hyperparathyroidism followed by the development of new-onset catatonia in a patient with schizoaffective disorder.

Methods: To allow for the safe resumption of lithium, the patient received laboratory screening of serum lithium, blood urea nitrogen, serum creatinine, calcium, and thyroid-stimulating hormone levels. The hypercalcemia was evaluated by measuring parathyroid hormone (PTH), ionized calcium, and 25-hydroxy vitamin D levels. Read More

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December 2020

Bi-Spectral Index-Guided Comparison of Propofol versus Etomidate for Induction in Electroconvulsive Therapy.

Anesth Essays Res 2020 Jul-Sep;14(3):504-509. Epub 2021 Mar 22.

Department of Anesthesiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Background: Previous studies have compared varying doses of propofol and etomidate for electroconvulsive therapy (ECT) without monitoring the depth of anesthesia. Seizure duration may vary with the depth of anesthesia.

Aim: This study aimed to compare the effects of bi-spectral index (BIS)-guided induction with propofol and etomidate on various parameters of ECT. Read More

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Correction to: Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample.

Eur Arch Psychiatry Clin Neurosci 2021 Jun 5. Epub 2021 Jun 5.

Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany.

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Methylome-wide change associated with response to electroconvulsive therapy in depressed patients.

Transl Psychiatry 2021 Jun 5;11(1):347. Epub 2021 Jun 5.

Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Electroconvulsive therapy (ECT) is a quick-acting and powerful antidepressant treatment considered to be effective in treating severe and pharmacotherapy-resistant forms of depression. Recent studies have suggested that epigenetic mechanisms can mediate treatment response and investigations about the relationship between the effects of ECT and DNA methylation have so far largely taken candidate approaches. In the present study, we examined the effects of ECT on the methylome associated with response in depressed patients (n = 34), testing for differentially methylated CpG sites before the first and after the last ECT treatment. Read More

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Does Electroconvulsive Therapy for Patients with Mood Disorders Extend Hospital Length of Stays and Increase Inpatient Costs?

Adm Policy Ment Health 2021 Jun 5. Epub 2021 Jun 5.

VA New England Mental Illness Research and Education Center, West Haven, USA.

Although randomized trials have shown that electroconvulsive therapy (ECT) is an effective and underused treatment for mood disorders, its impact on inpatient length of stay (LOS) and hospital costs are not fully understood. We analyzed private insurance claims of patients hospitalized for mood disorders who had continuous insurance for three months prior to an index hospitalization and six months after discharge (N = 24,249). Propensity score weighted linear models were used to examine the association of any ECT use, the number of ECT treatments, and time to first ECT treatment, with LOS and hospital costs adjusting for potential confounders. Read More

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Relapse after abrupt discontinuation of maintenance electroconvulsive therapy during the COVID-19 pandemic.

Acta Psychiatr Scand 2021 Jun 4. Epub 2021 Jun 4.

KU Leuven, Department of Neurosciences, Research Group Psychiatry, Neuropsychiatry, Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center KU Leuven (UPC KU Leuven), Leuvensesteenweg 517, 3070, Kortenberg, Belgium.

Objective: Maintenance electroconvulsive therapy (M-ECT) is considered an effective relapse prevention strategy in severe mood and psychotic disorders. How long M-ECT should be continued, and what the outcome is after its discontinuation has not been adequately studied. In our tertiary psychiatric hospital, M-ECT treatments were suspended at the start of the COVID-19 pandemic. Read More

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Low-dose ketamine does not improve the speed of recovery from depression in electroconvulsive therapy: a randomized controlled trial.

Braz J Psychiatry 2021 May 28. Epub 2021 May 28.

Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.

Objective: Electroconvulsive therapy (ECT) is a well-established therapeutic intervention for major depressive disorder. Recent literature has shown that the anesthetic agent ketamine has some antidepressant properties at low doses and may be an alternative therapy for treatment-resistant major depressive disorder. We hypothesized that the use of low-dose ketamine as an anesthetic adjunct in ECT would more rapidly improve depression while maintaining hemodynamic stability than ECT with propofol alone. Read More

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Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.

Am J Geriatr Psychiatry 2021 May 17. Epub 2021 May 17.

Department of Psychiatry (MCB, ETG, LSL, CHK), Icahn School of Medicine at Mount Sinai, New York, NY.

Objective: There is limited information regarding neurocognitive outcomes of right unilateral ultrabrief pulse width electroconvulsive therapy (RUL-UB ECT) combined with pharmacotherapy in older adults with major depressive disorder. We report longitudinal neurocognitive outcomes from Phase 2 of the Prolonging Remission in Depressed Elderly (PRIDE) study.

Method: After achieving remission with RUL-UB ECT and venlafaxine, older adults (≥60 years old) were randomized to receive symptom-titrated, algorithm-based longitudinal ECT (STABLE) plus pharmacotherapy (venlafaxine and lithium) or pharmacotherapy-only. Read More

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Electroconvulsive Therapy Impact on Memory Performance in Patients With Depression.

Rev Colomb Psiquiatr 2021 May 29. Epub 2021 May 29.

University of Caldas, Manizales, Colombia.

Introduction: The safety of electroconvulsive therapy has improved greatly over the last decades, making the potentially adverse effects on memory and other neurocognitive functions the main clinical aspect of concern in the present. In Colombia, the general population and healthcare professionals (even some psychiatrists) seem to have mostly negative opinions towards electroconvulsive therapy treatment, but maybe this could be reconsidered if more information is provided; therefore, the aim of the present study was to evaluate the changes in memory and the severity of the symptoms in a group of patients with severe depression before and after electroconvulsive therapy.

Methods: Twenty-three patients ranging in age from 23 to 70 years from the electroconvulsive therapy service at the San Juan de Dios Clinic (Manizales, Colombia) were recruited in order to assess the effect of electroconvulsive therapy on memory in patients with severe depression. Read More

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Efficacy and safety of electroconvulsive therapy plus medication versus medication alone in acute mania: A meta-analysis of randomized controlled trials.

Psychiatry Res 2021 May 19;302:114019. Epub 2021 May 19.

Mood Disorders Program, Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine. Cleveland, OH, USA. Electronic address:

Although some studies have reported the potential efficacy of electroconvulsive therapy (ECT) in the treatment of acute mania, there is no consensus on the matter. Therefore, we performed a meta-analysis to determine the efficacy and safety of ECT combination with medication (ECT-combo) vs. medication alone (Med-alone) in the treatment of acute mania. Read More

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Repetitive Transcranial Magnetic Stimulation for People With Treatment-Resistant Depression: A Health Technology Assessment.

Authors:

Ont Health Technol Assess Ser 2021 6;21(4):1-232. Epub 2021 May 6.

Background: Major depression is one of the most diagnosed mental illnesses in Canada. Generally, people are treated successfully with antidepressants or psychotherapy, but some people do not respond to these treatments (called treatment-resistant depression [TRD]). Repetitive transcranial magnetic stimulation (rTMS) delivers magnetic pulses to stimulate the areas of the brain associated with mood regulation. Read More

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Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases.

Front Pharmacol 2021 13;12:669638. Epub 2021 May 13.

Department of Agricultural Sciences, University of Naples Federico II, Potici, Italy.

Psychiatric disorders are frequently encountered in many neurological disorders, such as Alzheimer's and Parkinson diseases along with epilepsy, migraine, essential tremors, and stroke. The most common comorbid diagnoses in neurological diseases are depression and anxiety disorders along with cognitive impairment. Whether the underlying reason is due to common neurochemical mechanisms or loss of previous functioning level, comorbidities are often overlooked. Read More

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REM Sleep and Total Sleep Time Improvement After Routine Repetitive Transcranial Magnetic Stimulation in Active Duty Service Members With Depression.

J ECT 2021 Apr 26. Epub 2021 Apr 26.

From the Outpatient Behavioral Health Service, Eisenhower Army Medical Center, Fort Gordon Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta Neuroscience & Rehabilitation Center Pulmonary Disease Service, Eisenhower Army Medical Center, Fort Gordon, GA.

Objectives: The prevalence of depression and insomnia in the military are substantial. Several transcranial magnetic stimulation (TMS) studies have used self-report sleep data as secondary research outcomes; however, there are limited studies using the gold standard of polysomnography (PSG) to ascertain actual sleep changes. Here, we provide data from a pilot and feasibility study using PSG to measure sleep changes after repetitive TMS. Read More

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Administration of Electroconvulsive Therapy With an Anesthesia Machine: A Case Report of Electroconvulsive Therapy-Provoked Status Epilepticus Ablated With an Inhalant Anesthetic Agent.

J ECT 2021 Apr 26. Epub 2021 Apr 26.

Department of Anesthesiology and Pain Medicine Korea University Anam Hospital Seoul, Republic of Korea Department of Anesthesiology and Pain Medicine Dongguk University Ilsan Hospital Goyang, Republic of Korea DM/Statistics Institute Dongguk University Goyang, Republic of Korea Department of Anesthesiology and Pain Medicine Dongguk University Ilsan Hospital Goyang, Republic of Korea.

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Ventilation Adjustment in ECT During COVID-19: Voluntary Hyperventilation is an Effective Strategy.

Neuropsychiatr Dis Treat 2021 20;17:1563-1569. Epub 2021 May 20.

Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L'Hospitalet de Llobregat, Barcelona, Spain.

Purpose: Airway management is a key objective in adapted electroconvulsive therapy (ECT) protocols during the COVID-19 pandemic to prevent infection. The objective of this study was to describe the effectiveness of a modified ventilation procedure designed to reduce aerosol-generating bag-mask ventilation (BMV) and isolate possible droplets while maintaining adequate respiratory gas values in ECT sessions.

Materials And Methods: This prospective study analyzed the results of the modified protocol applied over a month. Read More

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Electroconvulsive therapy is associated with lower readmission rates in patients with schizophrenia.

Brain Stimul 2021 May 24;14(4):913-921. Epub 2021 May 24.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA.

Background: Electroconvulsive therapy is an important somatic treatment for severe mental disorders with established efficacy and safety. However, data on the relationship between ECT and the readmission rate of patients with schizophrenia are scarce. This study will explore the association between the administration of ECT and readmission rates using a machine learning method. Read More

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Long-term quality of life in treatment-resistant depression after electroconvulsive therapy.

J Affect Disord 2021 May 18;291:135-139. Epub 2021 May 18.

Department of Psychiatry, University of Utah, Salt Lake City, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA.

Background: Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression (TRD), and previous studies have demonstrated short-term improvements in quality of life (QoL) after ECT.  However, long-term QoL after ECT has not been studied, and the baseline patient characteristics that predict long-term QoL remain unknown.

Methods: Seventy-nine subjects with unipolar or bipolar TRD were enrolled in this prospective longitudinal observational study. Read More

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Comparative outcomes in electroconvulsive therapy (ECT): A naturalistic comparison between outcomes in psychosis, mania, depression, psychotic depression and catatonia.

Eur Neuropsychopharmacol 2021 May 22;51:43-54. Epub 2021 May 22.

School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia; Black Dog Institute, Hospital Road, Randwick, NSW, 2031, Australia; The Wesley Hospital, 7 Blake St, Kogarah, NSW, 2217, Australia; St. George Hospital, Gray St, Kogarah, NSW, 2217, Australia; Northside Group St Leonards Clinic, 2 Frederick St, St Leonards, NSW, 2065, Australia.

Electroconvulsive Therapy's (ECT) use and place in treatment guidelines varies worldwide with a primary indication of depression in Western countries and acute psychosis in Asian countries. There is sparse evidence about the relative effectiveness of ECT among different indications that may account for this discrepancy. We aimed to compare the clinical global impression of disease severity, cognitive change, subjective quality of life (QoL) and global functioning after ECT given for treatment of the indications of acute psychosis, mania, depression, psychotic depression and catatonia. Read More

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Relapse following bitemporal and high-dose right unilateral electroconvulsive therapy for major depression.

Acta Psychiatr Scand 2021 May 25. Epub 2021 May 25.

Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland.

Objective: Electroconvulsive therapy (ECT) is an effective acute treatment for severe and/or medication-resistant depression but maintaining remission following completion of a course remains a clinical challenge.

Methods: EFFECT-Dep Trial (ISRCTN23577151) participants with a DSM-IV major depressive episode who met remission criteria after a randomly assigned course of twice-weekly brief-pulse bitemporal (1.5 × seizure threshold) or high-dose (6 × seizure threshold) right unilateral ECT were monitored for relapse for 12 months. Read More

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Challenges and pitfalls in anesthesia for electroconvulsive therapy.

Best Pract Res Clin Anaesthesiol 2021 Jul 23;35(2):181-189. Epub 2020 Dec 23.

Department of Anaesthesiology, Hospital Clínic de Barcelona, IDIBAPS, CIBERSAM. University of Barcelona, Barcelona, Spain.

Electroconvulsive therapy (ECT) refers to the application of electricity to the patients' scalp to treat psychiatric disorders, most notably, treatment-resistant depression. It is a safe, effective, and evidence-based therapy that is performed with general anesthesia. Muscle relaxation is used to prevent injuries related to the tonic-clonic seizure caused by ECT. Read More

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Totally Implantable Venous-Access Device in Maintenance Electroconvulsive Therapy: A Retrospective Case Series.

J ECT 2021 Jun;37(2):e9-e12

Barcelona Clínic Schizophrenia Unit, Bipolar and Depressive Disorders Unit, Neuroscience Institute, Hospital Clínic de Barcelona.

Objectives: Electroconvulsive therapy (ECT) is an effective and safe treatment of certain severe mental disorders, but there are some barriers to the implementation of continuation/maintenance ECT courses in some cases. Repeated difficulties in achieving intravenous access before each session may contribute to premature ECT discontinuation. The placement of a totally implantable venous-access device (TIVAD) could be an alternative to overcome these difficulties in certain subjects. Read More

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Vagus Nerve Stimulation in Patients Receiving Maintenance Therapy With Electroconvulsive Therapy: A Series of 10 Cases.

J ECT 2021 Jun;37(2):84-87

From the Department of Clinical Research, Sheppard Pratt Health System, Baltimore, MD.

Objectives: Electroconvulsive therapy (ECT) is a mainstay in both acute and long-term management of difficult-to-treat depression. However, frequent acute courses of ECT or prolonged maintenance ECT treatment may increase adverse-effect burden and/or reduce patient acceptability. Therefore, we investigated the effectiveness of adjunctive vagus nerve stimulation (VNS) therapy as an alternative strategy for long-term maintenance treatment in ECT-responsive patients. Read More

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Staging and Combining Brain Stimulation Interventions: Vagus Nerve Stimulation and Electroconvulsive Therapy.

Authors:
Harold A Sackeim

J ECT 2021 Jun;37(2):80-83

From the Departments of Psychiatry and Radiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.

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