Edit concept Question Editor Create issue ticket

Electroconvulsive Therapy

Convulsive Therapies Electric


Presentation

  • Acute neurological and psychiatric manifestations are the common presenting symptoms.[ncbi.nlm.nih.gov]
Fishing
  • Aristotle and Pliny the Old mentioned the effects of the electrical discharges of the torpedo fish. From Scribonius Largus, we have a description of gut pain relief using this fish.[electroconvulsivetherapy.net]
  • ., aged cheese, aged or cured meats, soy sauce and soy bean condiments, salted fish, and red wine; see manufacturer‘s warning notices) or use certain medications (Level B) (American Psychiatric Association 2000 American Psychiatric Association. 2000.[dx.doi.org]
Developmental Delay
  • ECT has also been used in selected cases of depression occurring in the setting of multiple sclerosis, Parkinson's disease, Huntington's chorea, developmental delay, brain arteriovenous malformations, and hydrocephalus.[en.wikipedia.org]
  • However, caution should be used in women of child-bearing age, not only because of teratogenicity and high risk of developmental delay (Viguera et al. 2007 Viguera AC, Koukopoulos A, Muzina DJ, Baldessarini RJ.[dx.doi.org]
Plethora
  • There is a plethora of evidence for its efficacy, notwithstanding a lack of randomised controlled trials, such that "the excellent efficacy of ECT in catatonia is generally acknowledged".[en.wikipedia.org]
Regurgitation
  • We took additional precautions after each event, until she had no further episodes of regurgitation.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Adverse outcomes, including miscarriage with previous vaginal bleeding, vaginal bleeding, self-limited abdominal pain, and self-limited fetal spasms, were observed.[ncbi.nlm.nih.gov]
Psychiatric Manifestation
  • Acute neurological and psychiatric manifestations are the common presenting symptoms.[ncbi.nlm.nih.gov]
Olfactory Hallucination
  • To the best of our knowledge, this is the first report on delusions of reference and persecution, oneiric delusions and olfactory hallucinations associated with the course of ECT.[ncbi.nlm.nih.gov]
Psychiatric Manifestation
  • Acute neurological and psychiatric manifestations are the common presenting symptoms.[ncbi.nlm.nih.gov]
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]
Chorea
  • ECT has also been used in selected cases of depression occurring in the setting of multiple sclerosis, Parkinson's disease, Huntington's chorea, developmental delay, brain arteriovenous malformations, and hydrocephalus.[en.wikipedia.org]
Focal Neurologic Deficit
  • The patient developed recurrent focal neurological deficits after each ECT procedure, with neurological recovery within 48 hours post-ECT.[ncbi.nlm.nih.gov]

Workup

  • […] 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]
Hypocapnia
  • Search terms ('electroconvulsive therapy' and 'hyperventilation', 'ventilation', 'hyperoxygenation', 'hyperoxia', 'hypocapnia') were used to retrieve works from 1966 to June 2016.[ncbi.nlm.nih.gov]
ST Elevation
  • Two hours later, the patient experienced gastric pain and had increased troponin and natriuretic peptide levels and ST-elevation. After inotrope and anticoagulant treatment and replacement of antipsychotics, the patient remained stable.[ncbi.nlm.nih.gov]

Treatment

  • 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]
  • Rather, ECT is indicated as a first-line treatment.[primarypsychiatry.com]

Prognosis

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

Etiology

  • 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]

Epidemiology

  • News & Views Electroconvulsive therapy Electroconvulsive therapy Stuart Carney, associate director, John Geddes, professor of epidemiological psychiatry (john.geddes@psych.ox.ac.uk) 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]
  • And a 2010 survey of studies, published in the European journal now called Epidemiology and Psychiatric Sciences, came down strongly against the procedure. The authors cited brain damage, memory loss and a slightly increased risk of death.[dallasnews.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]

Prevention

  • 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]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!