We present a patient who received electroconvulsive therapy (ECT) for SSD with significant improvement in pain and gastrointestinal symptoms. We also present a brief literature review of similar cases treated with ECT. [ncbi.nlm.nih.gov]

• Antipsychotic Agent

  Second-generation antipsychotic agents in the treatment of acute mania: a systematic review and meta-analysis of randomized controlled trials. Arch Gen Psychiatry. 2007;64(4):442–55. PubMed CrossRef Google Scholar 43. Macritchie K, et al. [doi.org]

  Combining ECT and antipsychotic agents: benefits and risks. Convulsive Therapy. 1993; 9 :241–255. [ PubMed ] [ Google Scholar ] 38. Braga RJ, Petrides G. [ncbi.nlm.nih.gov]

  Second-generation antipsychotic agents in the treatment of acute mania: a systematic review and meta-analysis of randomized controlled trials. [dx.doi.org]

  However, several studies have investigated the efficacy and tolerability of alternative pharmacological agents that may be effective, including the newest atypical antipsychotic agents (e.g., paliperidone, sertindole), tetrabenazine, drugs that modulate [aetna.com]

• Inflammation

  The following MESH terms were used: Electroconvulsive therapy AND (inflammation OR immune OR immunology). RESULTS: Our review shows that there is an acute immuno-inflammatory response immediately following an ECT session. [ncbi.nlm.nih.gov]

  The role of immune genes in the association between depression and inflammation: a review of recent clinical studies. Brain Behav Immun. 31, 31-47. Connor, TJ, Starr, N, O’Sullivan, JB, and Harkin, A (2008). [doi.org]

• Swelling

  This barrier normally protects the brain from potentially damaging substances in the blood….breaching this barrier exposes nerve cells in the brain to chemical insults that can kill them…also leads…to swelling of the brain…swelling leads to local arrest [assembly.state.ny.us]

• Hypertension

  KEYWORDS: Electroconvulsive therapy; Idiopathic pulmonary arterial hypertension; Malignant catatonia; Pulmonary hypertensive crisis; Remifentanil [ncbi.nlm.nih.gov]

  The most common adverse effects in mothers are confusion, memory loss, muscle soreness, headache, hypertension, vaginal bleeding, placental abruption, uterine contractions and induction of premature labor. [doi.org]

  Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension [jama.ama-assn.org]

  high-grade atrioventricular block, and symptomatic ventricular arrhythmias, ECT raises the risk of symptoms from these cardiac conditions. [1] Patients with hypertension should be stabilized with antihypertensive medications before undergoing ECT. [ [emedicine.medscape.com]

• Ulcer

  Treatment of Catatonia Supportive Measures A broad range of complications of catatonia can occur, such as aspiration pneumonia, dehydration, muscle contractures, pressure ulcers, nutritional deficiencies, severe weight loss, thiamine deficiency, electrolyte [doi.org]

• Skin Disease

  Photo Credit Gracia Lam Personal Health A Little-Known Skin Disease That Can Disrupt People’s Sex Lives Patients deal with pain and itching and often encounter medical ignorance and mistreatment until affected tissues become irreparably scarred. [nytimes.com]

• Euphoria

  Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision-making, impulsive or risky behavior, substance abuse, and psychosis. [mayoclinic.org]

  Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision making, impulsive or risky behavior, substance abuse, and psychosis. [seattlentc.com]

• Psychiatric Manifestation

  Acute neurological and psychiatric manifestations are the common presenting symptoms. [ncbi.nlm.nih.gov]

• Seizure

  CONCLUSIONS: Adequacy of seizures, in the form of the degree of postictal suppression, was superior by determining the seizure induction time with BIS in both MST and ECT. [ncbi.nlm.nih.gov]

  […] to induce seizure. [arxiv.org]

  In terms of clinical efficacy, how much the electrical stimulus exceeds a patient’s seizure threshold— the minimum amount of electrical charge that induces a generalized CNS seizure 10 —is more important than the absolute intensity of the stimulus. 1 [mdedge.com]

• Catatonia

  OBJECTIVES: Lorazepam and electroconvulsive therapy (ECT) are effective treatments for catatonia. However, systematic data on these treatments in catatonia are limited. [ncbi.nlm.nih.gov]

  Breakey WR, Kala AK (1977) Typhoid catatonia responsive to ECT. Br Med J 2:357–359 CrossRef PubMed PubMedCentral Google Scholar 20. Kocha H, Moriguchi S, Mimura M (2014) Revisiting the concept of late catatonia. [doi.org]

• Headache

  The incidence rates of post-ECT agitation and headache in the Dex group were significantly lower than that in the Control group. [ncbi.nlm.nih.gov]

  Any headaches are treated with standard pain medications, like acetaminophen. Rare side effects include dental injuries; however, precautions are taken during the procedure to reduce that risk. [butler.org]

  Temporary side effects of today’s ECT may include: Irregular heart rhythm Rise in pulse and blood pressure Grogginess, muscle aches, nausea and headache Memory and learning difficulties typically return to normal in several weeks. [einstein.edu]

• Amnesia

  Retrograde amnesia is the most persistent cognitive adverse effect of electroconvulsive therapy (ECT); however, it is not known whether ECT has differential effects on autobiographical vs impersonal memories. [ncbi.nlm.nih.gov]

  Abstract Retrograde amnesia following electroconvulsive therapy (ECT) is a major concern for both patients and clinicians. [doi.org]

  At both the short- and long-term time points, patients treated with BL ECT had greater amnesia for autobiographical events, and the extent of this amnesia was directly related to the number of BL ECT treatments received. [nature.com]

[…] clinically evident hyperthyroidism, pheochromocytoma ), with sensitivity to anesthesia (eg, amyotrophic lateral sclerosis, porphyria, pseudocholinesterase deficiency ), or with cognitive sensitivity (eg, traumatic brain injury ) may require more extensive workup [emedicine.medscape.com]

How many treatments are given and how often? A patient usually receives an ECT treatment two to three times a week for a total of six to 12 treatments. ECT is an exceptionally effective medical treatment, helping 90% of patients who receive it. [riverpointbehavioral.com]

Electroconvulsive therapy treatment data including seizure length, number of treatments, and concurrent medications were extracted. [ncbi.nlm.nih.gov]

We review the efficacy of unmodified compared with modified treatment. [doi.org]

ECT relieves symptoms of depression within one to two weeks after beginning treatments. [medicinenet.com]

Prognosis Prognosis of catatonia is good, especially with early and aggressive treatment. In mood disorders, prognosis is probably better than in psychotic disorders. [doi.org]

Prognosis Mortality from ECT is not more than mortality from a general anaesthetic when undergoing minor surgery. [patient.info]

While it is estimated that 50% of these patients will experience a future return of symptoms, the prognosis for each episode of illness is good. Mania also often responds well to treatment. [medical-dictionary.thefreedictionary.com]

While it is estimated that as many as 50% of successfully treated patients will have future episodes of depression, the prognosis for each episode of illness is good. Mania also often responds well to treatment with ECT. [minddisorders.com]

A retrospective chart review of 5 patients with dementia of mixed etiologies was conducted comparing pretreatment and posttreatment scores on the Cohen-Mansfield Agitation Inventory. [ncbi.nlm.nih.gov]

The APA recommends that ECT be “considered only rarely for patients with delirium due to specific etiologies such as neuroleptic malignant syndrome and should not be considered initially as a substitute for more conservative and conventional treatments [aetna.com]

News & Views Electroconvulsive therapy Electroconvulsive therapy Stuart Carney, associate director, John Geddes, professor of epidemiological psychiatry ([email protected]) Centre for Evidence Based Mental Health Department of Psychiatry University [doi.org]

It is estimated that some 400 people a year need ECT in Ireland based on epidemiological analysis, yet only 257 people received it in 2013, according to the latest figures available from the Mental Health Commission. [irishtimes.com]

Recent epidemiological surveys in the United States show that the modern use of ECT is generally limited to evidence-based indications (Hermann et al., 1999). [doctorslounge.com]

Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. [oadoi.org]

TC pathophysiology remains unclear although it has been related to the burst of norepinephrine neurons. Psychosis has also been associated with catecholamine dysfunction, and excessive psychological stress with long-term norepinephrine dysfunction. [ncbi.nlm.nih.gov]

The diagnosis, pathophysiology and treatment of depressive illness. Cambridge (GB) : Cambridge University Press ; 2006. Google Scholar | Crossref 21. Sapolsky, R. Clucocorticoids and hippocampal atrophy in neuropsychiatric disorders. [doi.org]

This major gap in our knowledge prevents us at present from objectively quantifying the nature and extent of RAA associated with ECT. In turn, this hinders our identifying and implementing strategies for prevention or remediation of AM deficits. [ncbi.nlm.nih.gov]

Regarding relapse prevention, there are studies now looking at combining maintenance ECT with pharmacotherapy to prevent relapse. [primarypsychiatry.com]

Patients of ECT still need to be on medication and in therapy to prevent future episodes. Some patients will need to undergo a couple series of ECT, or use “maintenance ECT” (ongoing ECT treatment) if medication fails to prevent episodes. [healthcare.utah.edu]