Journal of Ect最新文献_第3页

Impact of Anesthesia on Electroconvulsive Therapy-Related Impairments in Global Cognitive Function in Patients With Treatment-Resistant Depression.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-17 DOI: 10.1097/YCT.0000000000001119

Léo Bernardoff, Martin Blay, Dimitri Thellier, Thierry D'Amato, Filipe Galvao, Emmanuel Poulet

{"title":"Impact of Anesthesia on Electroconvulsive Therapy-Related Impairments in Global Cognitive Function in Patients With Treatment-Resistant Depression.","authors":"Léo Bernardoff, Martin Blay, Dimitri Thellier, Thierry D'Amato, Filipe Galvao, Emmanuel Poulet","doi":"10.1097/YCT.0000000000001119","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001119","url":null,"abstract":"Introduction: Electroconvulsive therapy (ECT) in patients with treatment-resistant depression frequently leads to impairments in global cognitive function. Propofol and etomidate are the 2 most frequently used drugs for anesthetic induction during ECT. However, only few studies compared their differential impact on ECT-related impairments in global cognitive function.Methods: We studied retrospectively 75 patients hospitalized at Centre Hospitalier Le Vinatier (Bron, France) who met the DSM-V criteria for major depressive disorder and were treated with bilateral ECT to compare the effects of propofol and etomidate on ECT-related cognitive impairment. Global cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), and symptom severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), both before and after treatment. The primary endpoint of the study was the change in MoCA score.Results: We found no significant difference in MoCA score variation between the etomidate and propofol groups. There were also no significant differences in MADRS score variation, responder, remission rate or ECT parameters between the 2 groups (except duration of electroencephalogram crisis).Conclusions: In this retrospective study, choice of etomidate or propofol as anesthetic agent had no impact on the adverse effects associated with ECT on global cognitive function in patients with treatment-resistant depression.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maintenance Electroconvulsive Therapy for Treatment-Resistant Irritability in Autism Due to Depression in an Adolescent: A Case Study. 维持性电休克疗法治疗青少年抑郁症导致的自闭症顽固易怒症：病例研究。

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-17 DOI: 10.1097/YCT.0000000000001118

Enes Faruk Altunkilic, Gul Karacetin, Ipek Ege Gurel Ficicioglu, Ezgi Gurtay, Binay Kayan Ocakoglu, Aysegul Tonyali

{"title":"Maintenance Electroconvulsive Therapy for Treatment-Resistant Irritability in Autism Due to Depression in an Adolescent: A Case Study.","authors":"Enes Faruk Altunkilic, Gul Karacetin, Ipek Ege Gurel Ficicioglu, Ezgi Gurtay, Binay Kayan Ocakoglu, Aysegul Tonyali","doi":"10.1097/YCT.0000000000001118","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001118","url":null,"abstract":"Abstract: Irritability may be seen in patients with autism spectrum disorder, and it may be treated medically. The core features of the ASD diagnosis may confound presumed treatment resistance of irritability in ASD. Mood disorders should be in differential diagnosis if irritability is treatment-resistant in patients with autism. Electroconvulsive therapy (ECT) may be an effective treatment of choice in such patients. In this case report, we present a 16-year-old, 10-month-old male adolescent with autism spectrum disorder who was admitted to our inpatient service due to his self-harming and aggressive behavior with the possibility of severe harm resulting to others. His irritability was resistant to medical treatment; therefore, an underlying mood disorder was considered in the differential diagnosis. This case report presents a patient with treatment-resistant irritability in autism who was treated with fluoxetine and ECT. ECT is being continued as maintenance ECT. While this case is being written, he has received 36th maintenance ECT at a frequency of twice a week. This patient has benefited from a combination of fluoxetine and ECT. In conclusion, in the presence of irritability unresponsive to pharmacological and behavioral treatment in a patient with nonverbal autism spectrum disorder, an underlying mood disorder should be considered, and treatment should be arranged accordingly; ECT and maintenance ECT may be an effective treatment option.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Electroconvulsive Therapy in a University Psychiatric Hospital in Brazil.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-17 DOI: 10.1097/YCT.0000000000001129

Elaine Loureiro Pereira-Soares, Antonio Leandro Nascimento, Gabriel Caetano Dos Santos, Natia Horato, Antonio Egidio Nardi

{"title":"Use of Electroconvulsive Therapy in a University Psychiatric Hospital in Brazil.","authors":"Elaine Loureiro Pereira-Soares, Antonio Leandro Nascimento, Gabriel Caetano Dos Santos, Natia Horato, Antonio Egidio Nardi","doi":"10.1097/YCT.0000000000001129","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001129","url":null,"abstract":"Objectives: The aim of the study were to describe the practice of electroconvulsive therapy (ECT) at the Institute of Psychiatry (IPUB) of the Federal University of Rio de Janeiro (UFRJ) from 2015 to 2019 and to compare it with previous years at the same institute and with international practices.Methods: Sociodemographic and epidemiological data, along with information on ECT and anesthetic techniques, were collected from the medical records of all patients who received ECT at IPUB-UFRJ between 2015 and 2019.Results: A total of 238 patients underwent 4110 ECT sessions during the study period. A slight predominance of female patients (55.9%) was observed. Most patients were aged between 21 and 40 years (46.2%). Over half of the patients were outpatients (63.4%), with bipolar affective disorder being the most common diagnosis, accounting for 35.7% of ECT indications. Consent for ECT was obtained from all patients. Most treatments (85.2%) were conducted during the acute phase of illness. The average number of ECT sessions per patient was 5.4. All patients received anesthesia, and no deaths or severe complications related to ECT occurred. Monitoring cognitive effects and discharge criteria were the responsibility of the attending physician.Conclusions: The practice of ECT at IPUB-UFRJ adhered to both local and international guidelines. There has been a notable shift in the utilization patterns of ECT at the institute compared to previous years. Standardized monitoring of cognitive effects and discharge criteria remains essential.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The "Learned Intermediary": The Role of the Psychiatric Interventionist in Product Liability Lawsuits.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-10 DOI: 10.1097/YCT.0000000000001122

William V McCall, Rebecca E Strickland

{"title":"The \"Learned Intermediary\": The Role of the Psychiatric Interventionist in Product Liability Lawsuits.","authors":"William V McCall, Rebecca E Strickland","doi":"10.1097/YCT.0000000000001122","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001122","url":null,"abstract":"Abstract: Malpractice lawsuits brought by patient-plaintiffs alleging damages from medications or medical devices may entangle both the prescriber and the biomedical manufacturer. In this scenario, the prescriber may be viewed as a defendant, or alternatively as a \"learned intermediary\" (LI) between the patient and biomedical company. Recent legal actions in the United States involving manufacturers of electroconvulsive therapy devices have invoked the principle of the LI in the arguments. The plaintiff argued that the manufacturer held a major responsibility for providing to device operators warnings which lack scientific basis. This commentary will describe the legal concepts of the LI, and we will argue that the prescriber's duty to the patient is to provide relevant warnings with a scientific grounding, based upon the sum total of the prescriber's education. The courts opined that the conveyance of benefit and risk information to the patient should reflect what is \"known or knowable in light of the generally recognized and prevailing best scientific and medical knowledge available.\" Himes v. Somatics, LLC, 16 Cal. 5th 209, 222, 549 P.3d 916, 923 (2024) (emphasis added).","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of Switching to Right Unilateral From Bilateral Stimulation in Patients With Inadequate Seizures During Acute Electroconvulsive Therapy.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-05 DOI: 10.1097/YCT.0000000000001051

Ken Wada, Yoshikazu Masuda, Kei Itagaki, Atsuto Fujii, Ryo Ishikawa, Hisato Sangawa, Tatsunori Nagao

{"title":"Effectiveness of Switching to Right Unilateral From Bilateral Stimulation in Patients With Inadequate Seizures During Acute Electroconvulsive Therapy.","authors":"Ken Wada, Yoshikazu Masuda, Kei Itagaki, Atsuto Fujii, Ryo Ishikawa, Hisato Sangawa, Tatsunori Nagao","doi":"10.1097/YCT.0000000000001051","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001051","url":null,"abstract":"Aim: To determine the effectiveness of switching to right unilateral (RUL) from bilateral (BL) stimulation in patients with inadequate seizures during acute electroconvulsive therapy (ECT).Methods: A retrospective review of medical records was conducted of patients admitted to the Department of Psychiatry, Hiroshima Citizens Hospital, who received acute ECT from January 2019 to December 2021. Clinical characteristics including ECT procedures and adverse events were examined in patients who switched to RUL from BL.Results: Thirteen patients (7 male and 6 female patients, 66-89 years old) underwent switching to RUL from BL. The total number of ECT sessions including those for seizure titration per patient ranged from 10 to 31, whereas after switching, the number of RUL ECT sessions ranged from 2 to 18. Adequate seizure stimulation was observed from 0 to 11 sessions in patients who underwent RUL. The titrated seizure threshold for RUL was 25.2 mC in 3, 50.4 mC in 8, 75.6 mC, and 100.8 mC in 1. Clinical improvement, assessed by Clinical Global Impressions-Improvement score, was noted in all patients after switching. At the end of the acute ECT course, which included concurrent oral theophylline augmentation in 4 and shortened pulse width in 1 patient, the Clinical Global Impressions-Improvement score was very much improved in 9 and much improved in 3. All 13 patients finished the scheduled ECT course.Conclusion: Switching to RUL from BL can be considered as an effective treatment option for patients undergoing ECT with inadequate seizures.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is There an Optimal Electrode Placement for Patients With Schizophrenia Undergoing Electroconvulsive Therapy?

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-02-04 DOI: 10.1097/YCT.0000000000001108

Weng Jun Tan, Kimberly Wan Xin Choo, Jenies Hui Xin Foo, Phern Chern Tor

{"title":"Is There an Optimal Electrode Placement for Patients With Schizophrenia Undergoing Electroconvulsive Therapy?","authors":"Weng Jun Tan, Kimberly Wan Xin Choo, Jenies Hui Xin Foo, Phern Chern Tor","doi":"10.1097/YCT.0000000000001108","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001108","url":null,"abstract":"Abstract: Electroconvulsive therapy (ECT) is a recognized treatment option for patients with schizophrenia, especially when patients do not respond adequately to antipsychotic medication or when rapid response is needed in severe cases. The 3 common electrode placements, namely, bitemporal, bifrontal and right unilateral (RUL) modalities, have all been described by various studies to be efficacious in symptom reduction. However, the optimal electrode placement with the greatest success rate in the treatment of schizophrenia has yet to be ascertained. Furthermore, the benefit of switching ECT modalities after poor response to the initial electrode placement has not been well studied. Hence, to illustrate the twin issues of the optimal ECT modality as well as the effect of switching ECT modalities after initial nonresponse in patients with schizophrenia, we describe 2 distinct patients who underwent multiple courses of bifrontal and RUL ECT, but only responded well to bifrontal ECT. This is possibly due to the patients' anatomical differences as well as varying brain stimulation patterns produced by the different electrode placements. Thus, we believe that the prescription of ECT in patients with schizophrenia should be individualized, and a switch to a different ECT modality should be strongly considered if there is a lack of response to a particular modality.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electroconvulsive Therapy for Treatment-Resistant Depression in a Patient With Wolff-Parkinson-White Syndrome: A Case Report and Literature Review.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-01-28 DOI: 10.1097/YCT.0000000000001107

María Paula Gutiérrez-Alzate, Sebastián López-Ospino, Andrea Marcela Suárez-Chacón, Gina Tatiana Coral-Sánchez, Ángela R Acero-González

引用次数: 0

DBS Artifact During Postictal Generalized EEG Suppression After ECT.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-01-28 DOI: 10.1097/YCT.0000000000001114

Benjamin Nazif, Foroogh Najafi, Andrew Howard, Stefan Lang, Evan Shao, Chantelle Hrazdil, Fidel Vila-Rodriguez

引用次数: 0

Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-01-24 DOI: 10.1097/YCT.0000000000001111

Caili Ren, Simon Kung, Paul E Croarkin, Alexander Opitz, Brent P Forester, Adriana P Hermida, Martina Mueller, Sandeep R Pagali, Georgios Petrides, Stephen J Seiner, Isabel A Yoon, Maria I Lapid

{"title":"Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review.","authors":"Caili Ren, Simon Kung, Paul E Croarkin, Alexander Opitz, Brent P Forester, Adriana P Hermida, Martina Mueller, Sandeep R Pagali, Georgios Petrides, Stephen J Seiner, Isabel A Yoon, Maria I Lapid","doi":"10.1097/YCT.0000000000001111","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001111","url":null,"abstract":"Abstract: Electroconvulsive therapy (ECT) is an effective treatment for severe depression, especially in treatment-resistant cases. However, its potential cognitive side effects necessitate careful dosing to balance therapeutic benefits and cognitive stability. Recent advances in electric field (E-field) modeling offer promising avenues to optimize ECT dosing. This review synthesizes current knowledge on E-field modeling in ECT and explores its clinical applications. It examines the variability in E-field strengths and distributions induced by ECT and their impact on clinical outcomes. Additionally, the relationship between E-field strengths, neuroplasticity, and therapeutic efficacy is discussed. Translational studies of E-field-informed ECT are highlighted, emphasizing individualized optimal amplitude dosing and potential clinical applications. This review provides useful insights into how E-field modeling can improve the effectiveness of ECT while minimizing adverse effects, helping guide future research and clinical practice.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Retrospective Analysis of the Impact of Electroconvulsive Therapy on Anxiety Symptoms in Patients With Treatment-Resistant Depression.

IF 1.8 4区医学

Journal of Ect Pub Date : 2025-01-24 DOI: 10.1097/YCT.0000000000001113

Julia Laszcz, Chenyang Wang, Patricio Riva-Posse, Jonathan Kim, Valeriya Tsygankova, Ally Mandell, Hanna Rice, Adriana Hermida, Brandon M Kitay, Andrea Crowell, William M McDonald, Rachel Hershenberg

{"title":"A Retrospective Analysis of the Impact of Electroconvulsive Therapy on Anxiety Symptoms in Patients With Treatment-Resistant Depression.","authors":"Julia Laszcz, Chenyang Wang, Patricio Riva-Posse, Jonathan Kim, Valeriya Tsygankova, Ally Mandell, Hanna Rice, Adriana Hermida, Brandon M Kitay, Andrea Crowell, William M McDonald, Rachel Hershenberg","doi":"10.1097/YCT.0000000000001113","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001113","url":null,"abstract":"Background: Electroconvulsive therapy (ECT) is an effective treatment for treatment-resistant depression (TRD). There are limited data on the improvement of anxiety symptoms in patients receiving ECT for TRD.Objective: The aim of the study was to examine the extent to which anxiety symptom severity improves, relative to improvements in depressive symptoms, in TRD patients receiving an acute course of ECT.Methods: A retrospective chart review of 117 TRD patients who received an acute ECT course in a naturalistic outpatient setting was conducted. Symptomatic response was measured using the Beck Depression Inventory II and Generalized Anxiety Disorder 7 Scale. Two generalized estimating equation models assessed the degree of change in anxious symptoms relative to the change in depressive symptoms.Results: Both depression (-0.09, P < 0.001) and anxiety (-0.08, P < 0.001) improved after ECT treatment, with a greater standardized decrease for symptoms of depression. Higher levels of anxiety over the treatment (-0.42, P < 0.001) were associated with smaller antidepressant improvements.Conclusions: ECT may improve symptoms of anxiety in patients with TRD. Anxiety symptoms show a favorable trajectory of improvement, though to a lesser extent, relative to changes in symptoms of depression. Higher symptoms of anxiety throughout the treatment course may be a negative predictor of antidepressant response in ECT.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0