ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

None of 15 individual Hamilton depression scale items obtained at baseline, or five depression factors derived therefrom, significantly predicted an adjusted post-treatment Hamilton depression score after six unilateral or bilateral ECTs in a sample of 47 melancholic men. Excluding patients with nonmelancholic syndromes from ECT samples attenuates the previously reported predictive value of individual or grouped clinical psychopathological features of depression.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Electroconvulsive therapy (ECT)-induced prolactin release has been described by many investigators with the expectation that it reflects brain chemistry and thereby the neurochemical pathology of depression or the therapeutic impact of the ECT seizure, analogous to a blood drug level. Neuroendocrine evidence is reviewed to construct plausible mechanisms for ECT-induced prolactin release dependent on three sequential steps outside the brain: posterior pituitary change, transport to anterior pituitary, and prolactin release from anterior pituitary. These mechanisms also explain the prolactin elevations induced by suckling and by estradiol exposure. One mechanism posits seizure-induced interruption of the dopamine flux from posterior to anterior pituitary and consequent decrease of tonic inhibition on prolactin release. The other mechanism depends on a short-chain peptide prolactin-releasing factor. The substantial likelihood of strong posterior pituitary control of ECT-induced prolactin release suggests that it reflects brain chemistry only dimly.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Two groups of patients receiving bilateral, moderately suprathreshold electroconvulsive therapy (ECT) were compared in their cognitive functions after receiving either 0.5 mg atropine i.v. or no atropine before ECT. The patients were tested for cognitive functions after four treatments using various measures, including orientation; retrograde (verbal and visuospatial) memory for information acquired about 15 minutes pretreatment and tested for about 1 hour posttreatment; anterograde (verbal and visuospatial) memory for information acquired about 1 hour, 30 minutes posttreatment and tested for both immediately after learning and 20 minutes later; and retrieval from semantic memory as assessed by word fluency. We found no effect of 0.5 mg atropine on cognitive performance, even though anticholinergic drugs that cross the blood brain barrier might be expected to affect cognition after ECT.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Thirty-seven inpatients with major depression were assessed for postictal and interictal disorientation after they received 8 of 12 ECTs. In 20 patients, four of the eight assessments were after simulated ECT only. Only real, but not simulated, ECT produced postictal disorientation. Postictal disorientation was greatest after the first treatment, less after the second, and did not change in later assessments. It was shortest for person, longer for place, and longest for time, and showed a temporal time gradient. Interictal disorientation increased with the number of treatments. Two electrical stimulus variables (seizure duration and electrical stimulus intensity) correlated with the length of postictal disorientation. The influence of seizure duration and stimulus variables were independent of each other. The influence of the electrical stimulus variables was independent of the influence of demographic variables. These, however, did affect the length of postictal disorientation.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In a review of 734 published cases of neuroleptic malignant syndrome (NMS), we found 665 with sufficient data to allow statistical analyses. Forty-eight received ECT either during or shortly after an episode of NMS and were compared to control cases who received no specific treatment for their episode. We also compared the mortality rates in these two groups to data previously analyzed for specific drug treatments (i.e., amantadine, bromocriptine, L-dopa, and dantrolene). We find a substantially better outcome in the specific drug-treated (mortality rate of 9.7%) or ECT-treated (mortality rate of 10.3%) groups compared to the group receiving no specific treatment (mortality rate of 21%). We conclude that ECT is safe to use shortly after an episode of acute NMS has resolved and, furthermore, that ECT is probably safe in the actual treatment of NMS provided concomitant neuroleptics are discontinued.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In a patient with near-lethal catatonia, complications progressed from mild fever and tachycardia to severe hyperthermia, malignant hypertension, and cortical and subcortical dysfunction with increased urine cortisol and catecholamine concentrations, bilateral extensor toe reflexes, decerebrate posturing, and Cheyne-Stokes respirations. Electroconvulsive treatment reversed these changes and prevented almost certain death.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A 78-year-old woman with a major depression and subclinical hypothyroidism was successfully treated with ECT. Her abnormally augmented pretreatment thyrotropin-releasing hormone (TRH) stimulation test normalized. We discuss the interaction of electroconvulsive therapy (ECT) and the thyroid axis.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A 62-year-old man developed prolonged apnea during ECT with succinylcholine. He was found to have atypical cholinesterase. Subsequent ECTs were given using atracurium as the muscle relaxant. A review of the finding of atypical cholinesterase is presented along with a discussion of the use of atracurium.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We describe a depressed man with an asymptomatic arachnoid cyst of the left sylvian fissure who was successfully treated with ECT. Magnetic resonance imaging of the brain before and after the course of therapy revealed no change in the cyst nor any injury to the surrounding brain parenchyma.

ISSN:0749-8055    

出版商:OVID    

年代:1991

数据来源: OVID