Electroconvulsive therapy effects

Sackeim HA, Decina P, Kanzler M, et al Effects of electrode placement on the efficacy of titrated, low-dose ECT. Am J Psychiatry 144 1449-1455, 1987a Sackeim HA, Decina P, Prohovnik 1, et al Seizure threshold in electroconvulsive therapy. Effects of sex, age, electrode placement, and number of treatments. Arch Gen Psychiatry 44 355-360, 1987b... 

There is, however, a unique risk in the bipolar form that antidepressant treatment may trigger a switch into mania. This may occur either as the natural outcome of recovery from depression or as a pharmacological effect of the drug. Particular antidepressants (the selective serotonin reuptake inhibitors) seem less liable to induce the switch into mania than other antidepressants or electroconvulsive therapy. Treatment for mania consists initially of antipsychotic medication, for instance the widely used haloperidol, often combined with other less specific sedative medication such as the benzodiazepines (lorazepam intramuscularly or diazepam orally). The manic state will usually begin to subside within hours and this improvement develops further over the next 2 weeks. If the patient remains disturbed with manic symptoms, additional treatment with a mood stabilizer may help. 

Electroconvulsive therapy (ECT) is a highly efficacious treatment for MDD. The response rate is about 80% to 90% and even exceeds 50% for patients who have failed pharmacotherapy.16,17 ECT may be particularly beneficial for MDD that is complicated by psychotic features, severe suicidality, refusal to eat, pregnancy, or contraindication/non-response to pharmacotherapy.16,17 ECT is typically a very safe treatment alternative, but various cautions do exist, and the chief side effects are confusion and memory impairment.16... 

Electroconvulsive therapy (ECT) is used for severe mania or depression during pregnancy and for mixed episodes prior to treatment, anticonvulsants, lithium, and benzodiazepines should be tapered off to maximize therapy and minimize adverse effects. 

Shock Therapy. The early 20th century saw the development of the first effective biological treatments for depression, the shock therapies. The first shock treatments used injection of horse serum or insulin. A major advance in treatment occurred with the advent of electroconvulsive therapy (ECT) in 1934. Although initially used to treat schizophrenia, ECT was soon found to be highly effective for other psychiatric disorders including depression and mania. ECT remained the primary biological psychiatric treatment until the widespread release of psychiatric medications in the 1950s. 

Electroconvulsive Therapy (ECT). Introduced in the mid-1930s, ECT was initially used to treat schizophrenia (for which it is not effective) but was later found to be very effective in the treatment of major depression and mania. It gained widespread use and was the primary biological psychiatric treatment until the introduction of newer psychiatric medications in the 1950s. 

Shock Therapy. Insulin coma treatments were used in the early 1900s but offered no tangible improvement. Electroconvulsive therapy (ECT) arose in the 1930s and 1940s and was the hrst treatment to provide some relief from psychosis. However, its effects are only temporary and it proved too costly for continuous use. ECT continues to have some use for life-threatening catatonia, but it is mainly used to treat refractory depression or bipolar disorder. 

For very severe cases of depression, electroconvulsive therapy (ECT) can be tried. However, you must remember that demented patients are especially sensitive to the adverse memory effects of ECT. 

Repetitive TMS, unlike electroconvulsive therapy (ECT), uses sub-convulsive stimuli to treat depression. Compared to ECT, TMS has a potential to target specific brain regions and to stimulate brain areas thought to be primarily involved in depression while sparing areas like the hippocampus, thereby reducing the probability of cognitive side effects. However, the therapeutic efficacy of TMS as a treatment for depression is, unlike ECT, modest. Most TMS studies use high-frequency, fast stimulation (> 10 Hz) over the left dorsolateral prefrontal cortex, an area which has been... 

Ghaziuddin, N., Laughrin, D., and Giordani, B. (2000) Cognitive side effects of electroconvulsive therapy in adolescents. / Child Adolesc Psychopharmacol 10 269—276. 

Gurevitz, S. and Helme, W.H. (1954) Effects of electroconvulsive therapy on personality and intellectual functioning of the schizophrenic child. / Nerv Ment Dis 120 213—226. 

Lisanby, S.H., Maddox, J.H., Prudic, J., Devanand, D.P., and Sack-eim, H.A. (2000) The effects of electroconvulsive therapy on memory of autobiographical and public events. Arch Gen Psychiatry 57 581-590. 

Electroconvulsive therapy is one of the most efficacious treatments for adults with nonresistant (70% response) and resistant MDD (50% response) (APA, 2000). Because of the invasiveness of this treatment, however, it remains the treatment of choice only for the most severe, incapacitating forms of resistant depression. No studies have been carried out among adolescents, but anecdotal reports have suggested that adolescents with refractory depression may respond to ECT without significant side effects (Rey and Walter, 1997). Approximately 60% of adult patients treated successfully with ECT tend to relapse after 6 months (APA, 2000). Therefore, they must also receive maintenance treatment with antidepressants and sometimes maintenance ECT. There are no reports of use of maintenance ECT in adolescents. 

Grunhaus, L., Dannon, P.N., and Schreiber, S. (2000) Repetitive trans-craneal magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder an open study. Biol Psychiatry 47 314-324. 

Electroconvulsive therapy, an effective treatment for depression during pregnancy (Eorssman, 1955 Impastato et ah, 1964), should be considered when other... 

Electroconvulsive therapy [ECT] is mostly used for severe depression. Elowever, a balanced, extensive review of the literature by Sackeim s group (see Nobler et ah, Chapter 10, in this volume] reveals not only the remarkable potency and safety of this politically controversial mode of treatment, but also the multiplicity of its biological influence and impact on a diversified gamut of brain functions. ECT is probably also effective in acute manic states and might be viewed as a mood stabilizer. Whether or not maintenance ECT acts as a mood stabilizer is still unknown. It might be viewed as an antidepressant with a broad stabilizing effect. 

Inositol has been given in cases of diabetes for possible therapeutic effects on peripheral neuropathy at doses of 20 g/day with no side effects (Arendrup et al. 1989]. Recently, newborns were treated with inositol 80 mg/kg with marked benefit in respiratory distress syndrome, and no side effects were reported [Hallman et al. 1992]. In addition to the above, 10 psychiatrically healthy volunteers were given 12 g of inositol in a single dose, and no side effects or mood effects were reported [Levine et al. 1994] 15 patients were treated for 5 days each with 6 g of inositol daily for electroconvulsive therapy-induced confusion, with no clinical effects and no side effects (Levine et al. 1995b] and 4 patients with Li -induced electroencephalographic [LEG] abnormalities were treated for 7 days with 6 g daily of inositol [Barak et al. 1994] with minimal EEG effects and no side effects. 

Electroconvulsive therapy produces an extraordinary number of physiological and biochemical changes. A central challenge in uncovering mechanisms of therapeutic action is the separation of relevant effects from those that are epiphenomena of generalized seizure activity. This topic was reviewed in detail (Sackeim 1994a). From a practical standpoint, efforts are under way to identify markers of when an optimally therapeutic form of ECT has been administered. 

Electroconvulsive therapy (ECT) is an established and effective treatment of depression and some forms of schizophrenia. ECT is the treatment of choice in several types of depression (W. Z. Potter and Rudorfer 1993), especially severe depression (American Psychiatric Association Task Force on Electroconvulsive Therapy 1990 W. Z. Potter et al. 1991). The mechanism by which ECT exerts its antidepressant effect is still unknown. Studies of pharmacologically as well as of electrically induced convulsions suggest that the convulsion is a necessary condition for ECT s therapeutic effects (Cerletti and Bird 1938 Lerer 1987 Lerer et al. 1984). However, there is no satisfactory explanation for the clinical efficacy of convulsions. 

Evidence on the potential antidepressant efficacy of L-dopa is more voluminous, but also discouraging [Kapur and Mann 1992 Oren et al. 1994). Despite the definite effects of L-dopa on mood, its antidepressant efficacy, given with or without a peripheral decarboxylase inhibitor, is not established even in the subset of patients with psychomotor retardation and low pretreatment CSF HVA who are supposed to be particularly sensitive to its effects. Standard antidepressants or electroconvulsive therapy are the methods of choice in treating depression in patients with Parkinson s disease, in whom L-dopa appears to have limited or no antidepressant efficacy and has been suspected of producing depression [Cummings 1992). Furthermore, pro-... 

Abrams R Electroconvulsive Therapy. New York, Oxford University Press, 1992 Abrams R, Swartz CM, Vedak C Antidepressant effects of high-dose right unilateral electroconvulsive therapy. Arch Gen Psychiatry 48 746-748, 1991... 

Anderson DN, Wilkinson AM, Abou-Saleh MT, et al Recovery from depression after electroconvulsive therapy is accompanied by evidence of increased tetra-hydrobiopterin-dependent hydroxylation. Acta Psychiatr Scand 90 10-13, 1994 Anderson IM, Cowen PJ Effect of pindolol on endocrine and temperature responses to buspirone in healthy volunteers. Psychopharmacology 106 428-432, 1992 Anderson IM, Tomenson BM Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants a meta-analysis. BMJ 310 1433-1438, 1995... 

Anderson SMP, Godfrey PP, Grahame-Smith DG The effects of phorbol esters and lithium on 5-HT release in rat hippocampal slices. Br J Pharmacol 93 96P, 1988 Andrade C, Gangadhar BN, Swaminath G, et al Predicting the outcome of endogenous depression following electroconvulsive therapy. Convulsive Therapy 4 169-174, 1988... 

Calev A, Eink M, Petrides G, et al Caffeine pretreatment enhances clinical efficacy and reduces cognitive effects of electroconvulsive therapy. Convulsive Therapy 9 95-100, 1993... 

Coffey CE, Lucke J, Weiner RD, et al Seizure threshold in electroconvulsive therapy, 1 initial seizure threshold. Biol Psychiatry 37 713-720, 1995a Coffey CE, Lucke J, Weiner RD, et al Seizure threshold in electroconvulsive therapy (ECT), 11 the anticonvulsant effect of ECT. Biol Psychiatry 37 777-788, 1995b Cohen MR, Niska RW Localized right hemisphere dysfunction and recurrent mania. Am J Psychiatry 137 847-848, 1980... 

Devanand DP, Shapira B, Petty F, et al Effects of electroconvulsive therapy on plasma GABA. Convulsive Therapy 11 3-13, 1995 DeVane CL Pharmacokinetics of the newer antidepressants clinical relevance. Am J Med 97 (suppl6A) 13S-23S, 1994... 

Kellner CH, Beale MD, Pritchett JT, et al Electroconvulsive therapy and Parkinson s disease the case for further study. Psychopharmacol Bull 30 495-500, 1994 Kellner M, Wiedemann K, Kiieg J-C, et al Effects of the dopamine autoreceptor agonist roxindole in patients with depression and panic disorder (abstract). Neuropsychopharmacology 10 1018, 1994... 

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