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Electroconvulsive therapy cognitive impairment

C H Kellner, K G Farber, X R Chen, A Mehrotra, G D N Zipursky
OBJECTIVE: To systematically review the published clinical trials, case series, and case reports on left unilateral (LUL) electrode placement for clinical electroconvulsive therapy (ECT). METHOD: PubMed, Ovid Medline, and the Cochrane Library were searched for articles concerning LUL ECT. Number of patients, efficacy, and cognitive outcomes were extracted from the papers that met our inclusion criteria. RESULTS: A total of 52 articles were included in this review, consisting of 33 clinical trials, seven case series, and 12 case reports...
April 19, 2017: Acta Psychiatrica Scandinavica
Tyler S Kaster, Zafiris J Daskalakis, Daniel M Blumberger
OBJECTIVE: To determine the clinical effectiveness and cognitive impact of electroconvulsive therapy (ECT) in a large clinical sample of patients with schizophrenia and explore factors associated with treatment response and transient cognitive impairment. METHODS: We examined the clinical records of 144 patients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were treated at an academic mental health hospital from October 2009 to August 2014...
March 14, 2017: Journal of Clinical Psychiatry
Marieke J Henstra, Elise P Jansma, Nathalie van der Velde, Eleonora L Swart, Max L Stek, Didi Rhebergen
OBJECTIVE: Electroconvulsive therapy (ECT) is an effective treatment for severe late-life depression; however, ECT-induced cognitive side effects frequently occur. The cholinergic system is thought to play an important role in the pathogenesis. We systematically reviewed the evidence for acetylcholinesterase inhibitors (Ache-I) to prevent or reduce ECT-induced cognitive side effects. METHODS: A systematic search was performed in Pubmed, EMBASE, PsychINFO, and the Cochrane database to identify clinical trials investigating the effect of Ache-I on ECT-induced cognitive side effects...
March 10, 2017: International Journal of Geriatric Psychiatry
Jinichi Hirano, Akihiro Takamiya, Bun Yamagata, Syogo Hotta, Yukiko Miyasaka, Shenghong Pu, Akira Iwanami, Hiroyuki Uchida, Masaru Mimura
While the efficacy and tolerability of electroconvulsive therapy (ECT) for depression has been well established, the acute effects of ECT on brain function remain unclear. Particularly, although cognitive dysfunction has been consistently observed after ECT, little is known about the extent and time course of ECT-induced brain functional changes, as observed during cognitive tasks. Considering the acute antidepressant effects of ECT on depression, aberrant brain functional responses during cognitive tasks in patients with depression may improve immediately after this treatment...
February 22, 2017: Journal of Psychiatric Research
Dusan Kolar
Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term...
February 2017: Evidence-based Mental Health
Anna Antosik-Wójcińska, Łukasz Święcicki
OBJECTIVES: The aim of the study was to evaluate efficacy and safety of electroconvulsive therapy (ECT), in two age groups: before and after 60 years of age. METHODS: The study included 107 patients, 62 women and 45 men hospitalized in the Institute of Psychiatry and Neurology and treated with ECT in 2013 and 2014. 76 people were below 60 years; 31 people - above 60. The authors analyzed the course of 1086 ECTs, 747 sessions for patients before 60 and 339 in patients over 60 years of age...
October 31, 2016: Psychiatria Polska
Qibin Chen, Su Min, Xuechao Hao, Lihua Peng, Huaqing Meng, Qinghua Luo, Jianmei Chen, Xiao Li
OBJECTIVES: Converging evidence suggests that low doses of ketamine have antidepressant effects. The feasibility and safety of administering low doses of ketamine as adjunctive medication during electroconvulsive therapy (ECT) to enhance ECT efficacy and mitigate cognitive impairment has attracted much attention. This study investigated the effects of low doses of ketamine on learning and memory in patients undergoing ECT under propofol anesthesia. METHODS: This randomized, placebo-controlled, double-blind study recruited patients with moderate to severe depressive disorders who failed to respond to antidepressants and were scheduled to receive ECT...
November 3, 2016: Journal of ECT
Annemiek Dols, Filip Bouckaert, Pascal Sienaert, Didi Rhebergen, Kristof Vansteelandt, Mara Ten Kate, Francois-Laurent de Winter, Hannie C Comijs, Louise Emsell, Mardien L Oudega, Eric van Exel, Sigfried Schouws, Jasmien Obbels, Mike Wattjes, Frederik Barkhof, Piet Eikelenboom, Mathieu Vandenbulcke, Max L Stek
OBJECTIVE: The clinical profile of late-life depression (LLD) is frequently associated with cognitive impairment, aging-related brain changes, and somatic comorbidity. This two-site naturalistic longitudinal study aimed to explore differences in clinical and brain characteristics and response to electroconvulsive therapy (ECT) in early- (EOD) versus late-onset (LOD) late-life depression (respectively onset <55 and ≥55 years). METHODS: Between January 2011 and December 2013, 110 patients aged 55 years and older with ECT-treated unipolar depression were included in The Mood Disorders in Elderly treated with ECT study...
February 2017: American Journal of Geriatric Psychiatry
Gordon Parker, Stacey McCraw
BACKGROUND: The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS: All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review...
January 1, 2017: Journal of Affective Disorders
Mihriban Dalkıran, Akif Tasdemir, Tamer Salihoglu, Murat Emul, Alaattin Duran, Mufit Ugur, Ruhi Yavuz
People with schizophrenia have impairments in emotion recognition along with other social cognitive deficits. In the current study, we aimed to investigate the immediate benefits of ECT on facial emotion recognition ability. Thirty-two treatment resistant patients with schizophrenia who have been indicated for ECT enrolled in the study. Facial emotion stimuli were a set of 56 photographs that depicted seven basic emotions: sadness, anger, happiness, disgust, surprise, fear, and neutral faces. The average age of the participants was 33...
September 23, 2016: Psychiatric Quarterly
S V Biedermann, J M Bumb, T Demirakca, G Ende, A Sartorius
OBJECTIVE: Electroconvulsive therapy (ECT) is a highly effective and well-tolerated therapy for severe and treatment-resistant depression. Cognitive side-effects are still feared by some patients and clinicians. Importantly, cognitive impairments are among the most disabling symptoms of depression itself. METHODS: Patients suffering from a severe episode of depression were treated with either ECT or treatment as usual (TAU) in an in-patient setting. Matched healthy participants served as controls (HC)...
December 2016: Acta Psychiatrica Scandinavica
Christian Otte, Stefan M Gold, Brenda W Penninx, Carmine M Pariante, Amit Etkin, Maurizio Fava, David C Mohr, Alan F Schatzberg
Major depressive disorder (MDD) is a debilitating disease that is characterized by depressed mood, diminished interests, impaired cognitive function and vegetative symptoms, such as disturbed sleep or appetite. MDD occurs about twice as often in women than it does in men and affects one in six adults in their lifetime. The aetiology of MDD is multifactorial and its heritability is estimated to be approximately 35%. In addition, environmental factors, such as sexual, physical or emotional abuse during childhood, are strongly associated with the risk of developing MDD...
September 15, 2016: Nature Reviews. Disease Primers
Xin Gao, Fu-Zhi Zhuang, Shou-Jun Qin, Li Zhou, Yun Wang, Qing-Feng Shen, Mei Li, Michelle Villarreal, Lauren Benefield, Shu-Ling Gu, Teng-Fei Ma
Cognitive impairment is a common adverse effect of electroconvulsive therapy (ECT) during treatment for severe depression. Dexmedetomidine (DEX), a sedative-anesthetic drug, is used to treat post-ECT agitation. However, it is not known if DEX can protect against ECT-induced cognitive impairments. To address this, we used chronic unpredictable mild stress (CUMS) to establish a model of depression for ECT treatment. Our Morris water maze and sucrose preference test results suggest that DEX alleviates ECT-induced learning and memory impairments without altering the antidepressant efficacy of ECT...
September 30, 2016: Psychiatry Research
Shyam Sundar Arumugham, Jagadisha Thirthalli, Chittaranjan Andrade
INTRODUCTION: A substantial proportion (40-70%) of patients with treatment-resistant schizophrenia experience persistent symptoms despite an adequate clozapine trial. Brain stimulation techniques (BST) such as electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) have shown promise in medication-refractory schizophrenia. However, their co-administration with clozapine raises some safety concerns. AREAS COVERED: We conducted a systematic literature search through Pubmed and cross-references for relevant publications evaluating the safety and efficacy of combining BST with clozapine...
September 2016: Expert Review of Clinical Pharmacology
Divya Rani Kumar, Hank Ke Han, John Tiller, Colleen K Loo, Donel M Martin
OBJECTIVES: Directly inquiring about patient experiences of memory problems after ECT may alert clinicians to the existence of treatment side effects and provide an impression of their intrusiveness. In this study, we examined use of a novel and brief patient-reported measure to assess perceptions of memory side effects and their functional consequences before and after an acute ECT treatment course. These outcomes were compared with objective cognitive and subjective quality of life measures...
December 2016: Journal of ECT
Xiaomei Zhong, Hongbo He, Chunping Zhang, Zhijie Wang, Miaoling Jiang, Qirong Li, Minling Zhang, Xiong Huang
BACKGROUND: Treatment-resistant depression (TRD) is a growing clinical challenge. Electroconvulsive therapy (ECT) is an effective tool for TRD treatment. However, there remains a subset of patients who do not respond to this treatment with common anesthetic agent. Ketamine, a noteworthy anesthetic agent, has emerged as an augmentation to enhance the antidepressant efficacy of ECT. Trials of i.v. ketamine in TRD indicated dose-related mood enhancing efficacy. We aimed to explore anesthetic and subanesthetic concentrations of ketamine in ECT for TRD with respect to their impact on mood and neuropsychological effects...
September 1, 2016: Journal of Affective Disorders
Li Ren, Fan Zhang, Su Min, Xuechao Hao, Peipei Qin, Xianlin Zhu
Electroconvulsive therapy (ECT) is an effective treatment for depression, but it can induce learning and memory impairment. Our previous study found propofol (γ-aminobutyric acid (GABA) receptor agonist) could ameliorate electroconvulsive shock (ECS, an analog of ECT to animals)-induced cognitive impairment, however, the underlying molecular mechanisms remain unclear. This study aimed to investigate the effects of propofol on metaplasticity and autophosphorylation of CaMKIIa in stressed rats receiving ECS...
June 30, 2016: Psychiatry Research
Fan Zhang, Jie Luo, Su Min, Li Ren, Peipei Qin
This study investigated the effects of propofol and electroconvulsive shock (ECS), the analogue of electroconvulsive therapy (ECT) in animals, on tissue plasminogen activator (tPA) and its inhibitor (PAI-1) as well as the precursor of brain-derived neurotrophic factor (proBDNF)/mature BDNF (mBDNF) ratio in depressive rats. ECT is an effective treatment for depression, but can cause cognitive deficit. Some studies have indicated that propofol can ameliorate cognitive decline induced by ECT, but the underlying molecular mechanism is still unclear...
March 23, 2016: Brain Research
Sameer Hassamal, Paul Jolles, Ananda Pandurangi
AB, a 74-year-old Caucasian woman, was admitted for acute onset of psychosis, anxiety, and cognitive impairment. Pharmacotherapy was unsuccessful and the patient was referred for electroconvulsive therapy (ECT). Pre-ECT, (18) F-fluorodeoxyglucose-positron emission tomography (PET)/computed tomography showed extensive frontal, parietal, and temporal cortical hypometabolism suggestive of a neurodegenerative disease. After eight ECT sessions, the psychotic and anxiety symptoms as well as the cognitive impairment resolved...
November 2016: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Audrey Monica van Schaik, Didi Rhebergen, Marieke Jantien Henstra, Daniel J Kadouch, Eric van Exel, Maximilianus Lourentius Stek
Electroconvulsive therapy (ECT), albeit highly effective in treating depression, is frequently associated with cognitive impairment, either temporary or more persistent. Especially in older patients, who generally respond even better, serious cognitive impairment during the course of ECT may lead to premature termination of ECT. Treatment of this cognitive impairment is of utmost importance. In this case series report, we present the effect of rivastigmine, an acetylcholinesterase inhibitor, on cognitive impairment in three older, severely depressed patients during or after a course of ECT...
September 28, 2015: Clinics and Practice
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