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]

• Pain

  Somatic symptom disorder (SSD) is a challenging condition to treat with chronic pain, a common and disabling symptom. [ncbi.nlm.nih.gov]

  Some patients experience side effects such as headaches, nausea, and jaw pain, but the most concerning side effect is memory loss. [healthcare.utah.edu]

  From Scribonius Largus, we have a description of gut pain relief using this fish. Dioscorides and then Galen recommended the fish’s discharges for headaches. [electroconvulsivetherapy.net]

  Painful footage shows him twitching on a hospital bed as a brusque medical attendant administers shocks. He exclaims in pain and then says that half of his face has gone numb. [theguardian.com]

• Disability

  Somatic symptom disorder (SSD) is a challenging condition to treat with chronic pain, a common and disabling symptom. [ncbi.nlm.nih.gov]

  Confronted with mentally disabled individuals whose condition may lead to violence or inflicting it on others, society must carry out its duty of protecting those who are particularly vulnerable, while respecting and protecting these disabled individuals [doi.org]

• Surgical Procedure

  Since her previous course of ECT, she underwent gastric banding, a bariatric surgical procedure associated with increased risk of gastric regurgitation. [ncbi.nlm.nih.gov]

  This risk is typically regarded as being similar to the risks of having an outpatient surgical procedure under anesthesia. ECT treatments are extremely safe and severe medical complications are rare. [medicine.umich.edu]

• 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]

• Malaise

  […] schizoaffective 2% paranoid psychosis 3% brief psychotic disorder 5% others Indications: Drug resistance, life-threatening situation Gender: 56% women Age%, year groups: 48%, 20–40 38%, 41–50 7%, >60 Side effects: Tongue biting, loosening of dentures, postictal malaise [ncbi.nlm.nih.gov]

• Nausea

  In addition, the peak HR after ECT, seizure duration, recovery time, and incidence rates of post-ECT adverse effects (agitation, headache and nausea) were also recorded. [ncbi.nlm.nih.gov]

  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]

  Other side effects of ECT may include headaches, muscle pain, nausea, and short-term and possibly long-term memory problems. What To Think About A person having ECT will have a thorough physical examination prior to the treatment. [myhealth.alberta.ca]

  You may experience some short-term memory loss, confusion, nausea, headache, jaw pain, muscle aches and/or soreness immediately following ECT. These effects may last several hours. A few people have reported long-term memory loss. [ppimhs.org]

• Diarrhea

  The most frequent side effects of SSRIs are: gastrointestinal (nausea, vomiting and diarrhea), activation/restlessness (exacerbation of restlessness, agitation, sleep disturbances), sexual dysfunction (loss of erectile or ejaculatory function in men, [oadoi.org]

• 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]

• Osteoporosis

  1] Atracurium, mivacurium, rocuronium, and rapacuronium are alternatives to succinylcholine. [1] A nondepolarizing muscle relaxant may be indicated in patients with pseudocholinesterase deficiency, hypercalcemia, severe neuromuscular disease, severe osteoporosis [emedicine.medscape.com]

  HRT can also help prevent bone-thinning osteoporosis. However, the true contribution of hormones to depression is not known. Be sure to tell your doctor if you have had depression before and are considering HRT. [webmd.com]

• Myalgia

  The mortality rate has been estimated to be less than 1 death per 73 440 treatments. 20 The most common adverse effects (myalgia [1 in 5 patients], headache [1 in 3 patients]) are transient, lasting minutes to hours, and can be treated with analgesics [doi.org]

  Rare: Myalgia, nausea, fatigue. No deaths. Other: Clonidine given to hypertensive patients AvE: 8 Modified Anesthesia: Alfentanil or propofol and succinylcholine muscle relaxant Device: EMAI trademark Placement: BL Table C4 Europe N = 33. [ncbi.nlm.nih.gov]

• Anxiety Disorder

  Interventional psychiatry is a mental health specialty that uses electrical or magnetic stimulation, as well as some drug treatments, to alter brain circuitry and subsequently ease the symptoms of long-term depression, bipolar disorder and anxiety disorders [sutterhealth.org]

  ECT is a highly effective treatment for the following conditions: • severe depression (or treatment-resistant depression) • agitation or aggression in people with dementia • anxiety disorder • bipolar • severe mania • psychosis • severe suicidal thoughts [stvincentcharity.com]

  Subject: Medical Subject Headings (MeSH): Mental Health Mental Disorders Mental Health Services Confidentiality Legislation as Topic Attention Deficit Disorder with Hyperactivity Neurodevelopmental Disorders Anxiety Disorders Mood Disorders Schizophrenia [surgeongeneral.gov]

• 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]

• Convulsions

  Google Scholar Fink, M. ( 1979 ), Convulsive Therapy ( New York : Raven Press ). Google Scholar Finner, R.W. ( 1954 ), ' Duration of convulsion in electric shock therapy '. Journal of Nervous and Mental Disease, cxi, 530 - 7. [doi.org]

  Google Scholar Fink, M. ( 2001 ) Convulsive therapy: a review of the first 55 years. Journal of Affective Disorders, 63, 1 — 15. [isp.sagepub.com]

  They concluded, therefore, that if convulsions could be artifically produced in patients with schizophrenia, the illness could be cured. [medical-dictionary.thefreedictionary.com]

  He knew from medical literature that electric shocks produce epilepsy-like convulsions and wanted to cure the disease with Electroconvulsive Therapy (ECT). [electroconvulsivetherapy.net]

• 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]

• Confusion

  Electroconvulsive Therapy (ECT) Side Effects Confusion Confusion is a change in mental status in which a person is not able to think with his or her usual level of clarity. [medicinenet.com]

  We also review the potential drawbacks of unmodified treatment including fear and anxiety, worse postictal confusion, fracture risk, and the negative effects of unmodified treatment on how ECT is perceived in the general community. [ncbi.nlm.nih.gov]

  Confusion - Patients may experience a period of confusion that can last from a few minutes to several hours. Patients may be able to return to normal activities right away, or they may need to rest for several hours after treatment. [healthcare.utah.edu]

• 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]

[…] 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]