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Maintenance electroconvulsive

Sohag N Sanghani, Georgios Petrides, Charles H Kellner
PURPOSE OF REVIEW: ECT remains an important, yet underutilized, treatment for schizophrenia. Recent research shows that medication-resistant patients with schizophrenia, including those resistant to clozapine, respond well to ECT augmentation. The purpose of this article is to review recent studies of the use of ECT in the treatment of schizophrenia. RECENT FINDINGS: We performed an electronic database search for articles on ECT and schizophrenia, published in 2017...
March 9, 2018: Current Opinion in Psychiatry
Priyanka Thukral-Mahajan, Nilesh Shah, Gurvinder Kalra, Chittaranjan Andrade
Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits...
October 2017: Indian Journal of Psychiatry
Shane P Gill, Charles H Kellner
OBJECTIVES: Continuation or maintenance electroconvulsive therapy (ECT) is often provided as a strategy for post-ECT relapse prevention. However, the evidence has been insufficient until recently to produce clear consensus on what best practice maintenance ECT (mECT) should be like in a real world ECT clinical service. The aims of this article are to help fill this gap and to provide a comprehensive set of practical, clinically-based recommendations for ECT clinicians and services. METHODS: A workshop was held at the Royal Australian and New Zealand College of Psychiatry Congress in Adelaide on April 30, 2017...
February 7, 2018: Journal of ECT
Jeong Seok Seo, Won-Myong Bahk, Hee Ryung Wang, Young Sup Woo, Young-Min Park, Jong-Hyun Jeong, Won Kim, Se-Hoon Shim, Jung Goo Lee, Duk-In Jon, Kyung Joon Min
Objective: In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. Methods: Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies...
February 28, 2018: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Jacob J Strand, Lindsay L Warner, Mihir M Kamdar, Alice W Flaherty, Vicki A Jackson
Central pain syndromes are a complex, diverse group of clinical conditions that are poorly understood. We present a patient with progressive, debilitating central pain and co-existing mood disorders that was refractory to multimodal pharmacologic and nonpharmacologic therapies, but that ultimately responded to electroconvulsive therapy (ECT). The patient described it at various times as her skin being "lit on fire," "stabbed," "squeezed like a boa constrictor," or itching unbearably. She underwent a course of three sequential ECT treatments during her hospitalization and it dramatically decreased her pain...
January 12, 2018: Journal of Palliative Medicine
Sebastian Moeller, Neele Kalkwarf, Caroline Lücke, Diana Ortiz, Sonja Jahn, Christiane Först, Niclas Braun, Alexandra Philipsen, Helge H O Müller
RATIONALE: Up to one third of all schizophrenic patients are classified as having treatment-resistant schizophrenia (TRS). This subgroup faces remarkable medical and psychosocial damages, and pharmacotherapy is often limited due to nonresponse and/or side effects. Maintenance electroconvulsive therapy (M-ECT) might be effective in TRS. PATIENT CONCERNS: We present a case of a 26-year-old male patient with a TRS. DIAGNOSES: He received a treatment series of ECT sessions and a course of 24 M-ECTs...
December 2017: Medicine (Baltimore)
Melanie Isabella Selvadurai, Robyn Waxman, Omar Ghaffar, Ilan Fischler
We report a novel electroconvulsive therapy (ECT) regimen for sustaining the resolution of behavioural and psychological symptoms of dementia (BPSD) using alternating acute and maintenance ECT (M-ECT) trials. A 64-year-old man presenting with major neurocognitive disorder was admitted for acute behavioural disturbances and physical aggression. With few treatment options, the impact on patients' quality of life often supersedes cognitive symptoms and is a predictor of long-term institutionalisation. Recent studies indicate that ECT may be an effective and safe way to address BPSD...
January 5, 2018: BMJ Case Reports
E Stip, M-E Blain-Juste, O Farmer, M-P Fournier-Gosselin, P Lespérance
BACKGROUND: Electroconvulsive therapy is indicated in cases of catatonic schizophrenia following a failure of the challenge test with lorazepam or Zolpidem® . Some patients need maintenance treatment with ECT. Repetitive Transcranial Magnetic Stimulation (rTMS) and anodal Transcranial direct-current stimulation (tDCS) might be effective against catatonia. OBJECTIVE: Consider an alternative to ECT for a refractory patient. REVIEW: Twenty-one articles were identified mainly based on case reports series were found using search on Medline, Google Scholar, PsychInfo, CAIRNS...
December 11, 2017: L'Encéphale
Albert Cosculluela, Jesús Cobo, Erika Martínez-Amorós, Montse Paños, Angel M Santiago, Sara Crivillés, María Camposo, Joan C Oliva, Albert Granero, Diego J Palao
INTRODUCTION: Maintenance Electroconvulsive Therapy (mECT) is a biological long-term treatment in which patients receive ECT on periods from 2 to 4 weeks, during a variable period of time, usually for more than 6 months. Recent studies showed the efficacy of mECT in prevention of relapse and recurrences. Our study wants to demostrate the effectivity and cost-effectivity of this therapy in the naturalistic conditions of our area. METHODOLOGY: <AbstractText Label="DESIGN" NlmCategory="METHODS">Retrospective longitudinal study, with mirror analysis in naturalistic conditions...
November 2017: Actas Españolas de Psiquiatría
E Verwijk, J Obbels, H P Spaans, P Sienaert
BACKGROUND: Patients undergoing or about to undergo electroconvulsive therapy (ECT) are often afraid they will experience negative cognitive side-effects. AIM: To answer questions that patients and referring clinicians often ask about cognitive problems that can result from ECT. METHOD: To discuss, on the basis of clinical perception and literature, the cognitive problems resulting from ECT. RESULTS: The cognitive problems resulting from ect are threefold: short-term postictal confusion (immediately after the treatment), anterograde amnesia and retrograde amnesia...
2017: Tijdschrift Voor Psychiatrie
Morgane Lemasson, Julie Haesebaert, Louis Rochette, Eric Pelletier, Alain Lesage, Simon Patry
OBJECTIVE: As part of a quality improvement process, we propose a model of routinely monitoring electroconvulsive therapy (ECT) in Canadian provinces using linked health administrative databases to generate provincial periodic reports, influence policy, and standardise ECT practices. METHODS: ECT practice in Quebec was studied from 1996 to 2013, using longitudinal data from the Quebec Integrated Chronic Disease Surveillance System of the Institut National de Santé Publique du Québec, which links 5 health administrative databases...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Sibel Çakir, Nuran Çağlar
INTRODUCTION: Electroconvulsive therapy (ECT) is known to be an effective option in the treatment of mood disorders, especially resistant depression. However, the remission achieved by ECT was reported to be not long lasting enough. The aim of the present study was to investigate the relapse/recurrence rates and associated risk factors during the first year after ECT in patients diagnosed with mood disorders. METHODS: In a naturalistic observation, patients diagnosed with unipolar depressive disorder or a depressive episode of bipolar disorder and who had achieved remission by ECT were followed up for at least one year...
September 2017: Noro Psikiyatri Arsivi
Fady Rachid
Major depressive disorder is a highly prevalent condition with significant morbidity and mortality. Recurrent episodes occur in greater than 50% of patients within a one year period despite treatment with antidepressant medications, electroconvulsive therapy and psychotherapy. Longer antidepressant treatment may prevent relapses and recurrences. Urgent therapeutic alternatives are needed such as maintenance repetitive transcranial magnetic stimulation. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of this technique in the long-term treatment and relapse prevention of depression...
September 19, 2017: Psychiatry Research
Tamonud Modak, Saurabh Kumar, Arghya Pal, Rishab Gupta, Raman Deep Pattanayak, Sudhir Kumar Khandelwal
A 22-year-old male diagnosed with bipolar affective disorder presented to us with a 3(rd) episode mania resistant to both olanzapine and haloperidol as well as electroconvulsive therapy. He, however, responded to chlorpromazine (CPZ) which was also effective as a mood stabilizer. The patient had a relapse of his illness when CPZ was stopped and responded again when it was started. The case demonstrates that CPZ may have a role in as both an anti-manic agent and for the maintenance for bipolar disorders. The possible underlying mechanism for this role is also discussed...
July 2017: Indian Journal of Psychological Medicine
Isobel A Rosenthal, Charles H Kellner
Because of the severe nature of psychiatric illness, electroconvulsive therapy (ECT) is not always an "elective procedure." The pre-ECT medical evaluation, although important, should not be an impediment to timely ECT. We argue that an arbitrary regulation requiring new assessments every 30 days may be unduly burdensome and unnecessary. The small medical risk of treatment should be weighed against the potential psychiatric risk (including suicide) of delayed treatment.
June 28, 2017: Journal of ECT
Ejder Akgun Yildirim, Munevver Hacioglu Yildirim, Elif Carpar, Irmak Sarac
INTRODUCTION: Treatment of persistent genital arousal disorder (PGAD), as a chronic and disabling condition, implicates substantial compelling complexities. METHODS: In this case series, seven women diagnosed with PGAD who were referred to the Sexual Dysfunction Unit of Psychotherapy Outpatient Clinic of Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey between 2006 and 2009 were included. All patients were previously resistant to other antidepressants, antipsychotics and antiepileptics...
December 2017: Journal of Psychosomatic Obstetrics and Gynaecology
Richard D Weiner, Irving M Reti
ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II...
April 2017: International Review of Psychiatry
Karina Karolina Kedzior, Maria Schuchinsky, Imke Gerkensmeier, Colleen Loo
The present study aimed to systematically compare the cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and electroconvulsive therapy (ECT) in head-to-head studies with major depression (MDD) patients. A systematic literature search identified six studies with 219 MDD patients that were too heterogeneous to reliably detect meaningful differences in acute cognitive outcomes after ECT vs. HF-rTMS. Cognitive effects of brain stimulation vary depending on the timeframe and methods of assessment, stimulation parameters, and maintenance treatment...
August 2017: Journal of Psychiatric Research
Yuki Imoto, Eri Segi-Nishida, Hidenori Suzuki, Katsunori Kobayashi
Electroconvulsive therapy (ECT) is a highly effective and fast-acting treatment for depression. Despite a long history of clinical use, its mechanism of action remains poorly understood. Recently, a novel cellular mechanism of antidepressant action has been proposed: the phenotype of mature brain neurons is transformed to immature-like one by antidepressant drug treatments. We show here that electroconvulsive stimulation (ECS), an animal model of ECT, causes profound changes in maturation-related phenotypes of neurons in the hippocampal dentate gyrus of adult mice...
March 2, 2017: Molecular Brain
Moshe Isserles, Zafiris J Daskalakis, Sanjeev Kumar, Tarek K Rajji, Daniel M Blumberger
BACKGROUND: Dementia frequently presents with aggression, agitation, and disorganized behavior for which current treatment is partially effective and is associated with significant adverse effects. OBJECTIVE: The aim of this study was to retrospectively assess the clinical effectiveness and tolerability of electroconvulsive therapy (ECT) in a sample of patients with neuropsychiatric symptoms of dementia (NPS) and to explore factors associated with response and with cognitive adverse effects...
2017: Journal of Alzheimer's Disease: JAD
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