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At least 19 recordsLinked to original sources
PubMed1979

Succinylcholine drug interactions during electroconvulsive therapy.

Electroconvulsive therapy (ECT) is frequently described as being almost free of absolute contraindications. However, drug interactions with succinylcholine pose potential hazards to which this paper calls attention. In addition to its neuromuscular-blocking action, succinylcholine has other acetylcholine-like effects. Drugs which inhibit cholinesterase activity or which inhibit acetylcholine release or synthesis may produce prolonged respiratory paralysis when combined with succinylcholine. The increasing longevity of the population receiving chemotherapy for physical ailments implies that greater numbers of these patients may also become candidates for ECT and therefore be at risk for adverse drug interactions with succinylcholine. Of particular importance to the psychiatrist are the various psychotropic drugs that have been reported to interact with succinylcholine. Precautions in using drug combinations and treatment of complications are described.

Animals↗
PubMed1976

Prolactin response to electroconvulsive therapy.

Prolactin response to electroconvulsive therapy (E.C.T.)was investigated in nine patients with endogenous depression. Four patients undergoing minor gynaecological surgery who had had the same type of intravenous anaesthesia as the E.C.T. group were studied as controls. 15 minutes after E.C.T. there was a 10 to 50 fold increase in serum-prolactin in eight of the patients. The effects of anaesthesia and surgery on serum-prolactin in the controls were negligible.

Adult↗
PubMed1979

Enhanced 5-hydroxytryptamine-mediated behavioural responses in rats following repeated electroconvulsive shock: relevance to the mechanism of the antidepressive effect of electroconvulsive therapy.

Treatment of rats with one electroconvulsive shock (ECS) per day for 10 days enhanced the hyperactivity syndrome produced by administration of tranylcypromine (10 mg kg-1) and L-tryptophan (50 mg kg-1) given 24 h after the final shock. Similar enhancement was seen whether the shock was alternating sinusoidal or direct current (fractionated), whether it was given through unilaterally or bilaterally placed electrodes and whether or not a neuromuscular blocking agent (fazadinium) was used. Five shocks spread over 10 days or 8 shocks spread over 17 days were similarly effective, whilst 8 shocks in 1 day were ineffective. Therefore when ECS are given to rats in ways similar to those in which electroconvulsive therapy is given to patients with depression, enhancement of behavioural responses to increased 5-HT function is produced.

Animals↗
PubMed1979

The natural history of acute organic mental syndrome after bilateral electroconvulsive therapy.

Thirty-one patients undergoing electroconvulsive therapy (ECT) were followed prospectively for the development of acute organic mental syndrome (AOMS); 15 patients (48.4%) developed AOMS during ECT. For these 15 patients, the average number of ECTs before development of AOMS was 5.5 with average duration of AOMS being 20.1 days. Comparison of these 15 patients to the 16 patients who did not develop AOMS for diagnoses, demographic data, pre-ECT laboratory data, and medications, differed only in exposure to psychoactive medications and prior presence of major medical illness.

Acute Disease↗
PubMed1979

Memory complaint after electroconvulsive therapy: assessment with a new self-rating instrument.

Memory complaints before bilateral electroconvulsive therapy (ECT), 1 week after ECT, and 6 months after ECT were assessed in 35 patients using a newly developed self-rating scale. Memory complaints that occurred 1 week after ECT differed quantitatively and qualitatively from memory complaints that occurred before ECT. Six months later, memory complaints qualitatively resembled the complaints reported 1 week after ECT and differed sharply from those reported before ECT. It was suggested that a patient's impression of his memory is altered by bilateral ECT and that this altered impression persists in gradually diminishing form for at least 6 months after a typical course of treatment. Since the self-rating instrument used here appeared to differentiate between memory complaints associated with depression (before ECT) and memory complaints associated with amnesia (1 week after ECT), this instrument may be useful in a variety of settings where there is interest in human memory function.

Adult↗
PubMed1979

The treatment of psychotic major depressive disorder with drugs and electroconvulsive therapy.

A retrospective chart review of 54 patients demonstrating depression with psychotic symptoms was accomplished with the use of Research Diagnostic Criteria (RDC) for diagnosis of psychotic major affective disorder. Patients received adequate trials of either tricyclic antidepressants alone, antipsychotics, the two in combination, or electroconvulsive therapy (ECT). Antidepressants alone were found to be ineffective or only partially effective in treating psychotic depression unless somatic or depressive declusions were the only psychotic symptoms. Antipsychotics alone were usually effective in providing at least a partial response, particularly with psychotic symptoms. Excellent responses of the depressive and psychotic elements were provided with ECT, ECT with antipsychotic medication, and the combination of antidepressant and antipsychotic medications. These latter treatments may be the most appropriate for depression with psychotic features.

Adult↗
PubMedDate not supplied

Arterial blood-gas analyses during electroconvulsive therapy in a parturient.

Arterial blood gases and vital signs were monitored in a patient receiving electroconvulsive therapy (ECT) during the third trimester of pregnancy. Alterations in blood pressure and heart rate were similar to those noted in prior studies. Pretreating with 100 percent oxygen (02) and assisting ventilation until return of adequate spontaneous respirations, prevented hypoxemia, significant hypercarbia, and cardiovascular changes. The administration of succinylcholine prevented the systemic manifestations of the electrically-induced seizure. One fetal arrhythmia occurred, apparently unrelated to changes in maternal Pa02, and resolved spontaneously. This technic of anesthesia would appear to be acceptable for ECT in the parturient.

Adult↗
PubMed1979

Electroconvulsive therapy: an overview.

Modifications in technique, including the use of anesthesia and muscle-relaxing drugs, make electroconvulsive therapy safe and easy to administer. There are few contraindications, complications are rare, and efficacy is well-documented.

Adult↗
PubMed2026

Ictal electroencephalography and heart rate as treatment criteria in electroconvulsive therapy: a systematic review of the literature.

BACKGROUND: Decades before the emergence of precision medicine, psychiatrists raised the question of whether specific seizure characteristics could help optimize electroconvulsive therapy (ECT), as relationships between some of these characteristics and better outcomes were found. From 1990 onward, researchers focused on electroencephalography (EEG) and cardiovascular markers, which were broadly adopted by guidelines worldwide. However, the prognostic value of these markers is still controversial. Here, we provide a systematic summary of the studies on this topic. METHODS: We conducted a literature review on the use of ictal EEG and heart rate as outcome predictors in ECT using the PubMed, EMBASE, Cochrane and PsycINFO databases. RESULTS: Thirty-seven studies addressing more than 100 quality markers fulfilled our inclusion criteria. Single EEG markers were assigned to five categories (postictal inhibition, amplitude, coherence, regularity, and seizure duration). Heart rate and composite markers were considered separately. In contrast to single EEG markers, heart rate and composite markers could be consistently linked to better outcomes in patients with depression. Only a few studies on schizophrenia could be retrieved. CONCLUSION: Multiparametric markers outperformed single markers. Furthermore, changes in heart rate during seizures were related to better outcomes. Although clinical assessment remains the cornerstone of treatment guidance decisions, EEG and cardiac monitoring could help prevent insufficient seizures during the period preceding clinical improvement. Evidence on schizophrenia remains limited. More randomized trials are needed to analyze the role of composite markers as prognostic tools.

Humans↗
PubMed1978

Effect of electroconvulsive therapy on cardiac rhythm, conduction and repolarization.

Because sympathetic stimulation has been implicated in the genesis of arrhythmias, we studied the effects on arrhythmias of electroconvulsive therapy (ECT). Fifteen psychiatric patients (male: 8, female: 7, age: 19-51, mean: 29.8) without known heart disease underwent 24-hout Holter recordings before, during, and after ECT (25 episodes). All patients were taking psychotropic drugs and received atropine (0.4-1.2 mg, mean: 1.1 mg IV), methohexital, and succinylcholine prior to ECT. Following ECT, mean maximum heart rate increased (106 +/- 3.2 to 142 +/- 6.0 beats/min, p less than .001), PR interval decreased (149 +/- 3.3 to 131 +/- 3.7 msec, p less than .001) and QTc interval increased (132 +/- 6.5 to 454 +/- 9.7 msec, p less than .001) compared to values obtained after atropine administration. Mean PVC or PAC frequently immediately after ECT or per 24 hours did not change significantly (PVC per 24 hours 6.8 +/- 3.2 to 10.4 +/- 6.4, NS; PAC per 24 hours 0.4 +/- 0.3 to 0.3 +/- 0.2, NS) and no complex arrhythmias were noted. Rate and PR changes suggest adrenergic effects of ECT and QTc increase may be due to imbalanced sympathetic discharge. Autonomic stimulation produced by ECT did not induce arrhythmias in these patients without heart disease. The possible antiarrhythmic role of psychotropic agents or premedication is unknown.

Adult↗
PubMed1979

Electroconvulsive therapy following pituitary surgery.

A 39-year-old female with a history of three psychotic episodes in 6 months developed Cushingoid features and catatonia. Despite the surgical removal of a pituitary basophil adenoma and treatment with neurleptics, her catatonia worsened. Electroconvulsive therapy provided rapid, life-saving relief for this patient. Patient characteristics are discussed and treatment recommendations provided.

Adenoma, Basophil↗
PubMed1977

The effectiveness and safety of electroconvulsive therapy (ECT).

Over the past several decades, psychopharmacological treatments in psychiatry have been subjected to intensive methodological scrutiny in the continual assessment of their efficacy and safety. Although one of the most dramatic and controversial therapeutic approaches in psychiatry, electroconvulsive therapy (ECT) has not received the same concentrated, systematic attention. Through a comprehensive literature search, the present authors have attempted to provide answers relating to the efficacy and the safety of conventional ECT and some of its more prominent variations. Although specific discernible trends are reported in the text, results of the survey are too disparate for a simplistic summary statement to be made regarding efficacy in all diagnostic categories. As with most somatic treatments in psychiatry, bilateral ECT does present some apparent risk, reduced but not entirely eliminated by precautionary techniques, which must be weighed against the possible benefits to be derived in a given case. Other variations of ECT offer promise of fewer side effects but must be accepted as standard clinical practice.

Acute Disease↗
PubMed1977

Psychopharmaca and electroconvulsive therapy in relation to viral antibodies and interferon. Experimental and clinical study.

Chlorpromazine (CHP) in a concentration of 8.3 microgram per ml medium inhibited attachment and multiplication of CEC and of various cell lines. The same CHP concentration applied to grown CEC monolayers inhibited the growth of TBEV but not the growth of HHV 1, while interferon was slightly stimulated. The clinical course of fatal subcutaneous TBEV infection in mice was not affected by daily CHP treatment while brain and serum interferon were stimulated. Antibody formation in TBEV infected or HHV 1 immunized mice was not affected significantly by CHP application. The following data were obtained in a longitudinal study on 28 hospitalized schizophrenic patients: 89 percent of them revealed at least some serological findings which indicate an actual HHV 1 infectious process-elevated NAB titers, high ratio between complement requiring and complement not requiring NAB titers. A low interferon activity was observed in serum and cerebrospinal fluid of 93 percent and 14 percent patients, respectively. No regular correlation between HHV 1-NAB-both complement requiring and complement not requiring-and of interferon on one side and between hospitalization. CHP treatment and electroconvulsive therapy on the other side has been observed.

Animals↗