ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In our sample of 15 hospitalized patients with severe psychotic depression, six responded to therapy with tricyclic antidepressants combined with neuroleptics. Of the nine nonresponders, eight showed an excellent clinical response to electroconvulsive therapy (ECT). The clinical outcome after 6 months of treatment was similar in both groups. We recommend that protracted, complicated trials of pharmacotherapy be reevaluated in psychotic depression. A prospective comparative study of ECT and pharmacotherapy is needed to define the optimal treatment for psychotic depression.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Patient reports of systemic side effects and cognitive impairment were obtained the afternoon of each treatment during the electroconvulsive therapy (ECT) course. Side effects were grouped a priori as reflecting physical complaints, perceived cognitive impairment, and as mood-related. Patients randomly assigned to bilateral ECT reported more cognitive impairment than patients who received right unilateral ECT. There were indications that the unilateral ECT group had greater physical/somatic complaints. Patients who responded to ECT differed from nonresponders only on the more explicitly mood-related items. Generally, the findings supported the desirability of extending studies of patient reports of ECT adverse effects to include subjective systemic side effects in addition to subjective cognitive impairment.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Serial dexamethasone suppression tests (DST), obtained during a course of electroconvulsive therapy in 43 severely depressed patients, did not exhibit relationships between the initial DST, final DST, or the change in DST with clinical outcome measures at the time of discharge. In 37 patients reviewed six months after discharge, no relationship with the continuation of improvement, rehospitalization, or suicide was found. We are unable to confirm a clinical application for the DST in the management of patients during a course of convulsive therapy.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Clinicians become concerned when ECT is contemplated in an individual with a neurological disorder. In this review, the authors summarize the reports on the use of ECT in the presence of neurological disease. Because blood pressure, cerebral blood flow, and intracranial pressure rise with ECT, space-occupying lesions with increased intracranial pressure, cerebral aneurysm, recent head trauma, or active CNS infection pose special concerns for ECT treatment. In this review, we conclude that epilepsy and states with lowered seizure threshold may predispose to prolonged seizures. A history of head injury or stroke probably does not increase risk. Toxic/metabolic disorders are not contraindications to ECT, although correction of the underlying imbalance is a first priority. Extrapyramidal, demyelinating, and neuromuscular disorders pose little increased risk. Indeed, in Parkinson's Disease, ECT may be beneficial for the motor symptoms. As a general rule, it seems advisable to treat the underlying disorder prior to beginning ECT.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A depressed woman with multiple sclerosis was successfully treated with electroconvulsive therapy without any adverse effects to her neurologic status. Magnetic resonance imaging of the brain was performed before and after the course of therapy and revealed no change in the white matter lesions visualized on spin-echo images.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Huntington's disease (HD) is a progressive neurological disorder characterized by choreiform movements, dementia, and psychiatric symptoms. The psychiatric symptoms often lead to long-term psychiatric hospitalization. We report the case of a 49-year-old woman with HD of 1 year's duration who presented with an organic psychotic syndrome with voices telling her to kill herself or her children. The psychosis was refractory to neuroleptic treatment (up to 1,250 mg chlorpromazine equivalents per day). Depressive symptoms emerged but were neither of a magnitude nor of a duration to suggest a major affective disorder. Nonetheless, we treated the patient empirically with antidepressants, which had to be discontinued because of symptomatic orthostatic hypotension. Based on the persistent psychosis with suicidal and homicidal ideation and possible long-term state psychiatric hospitalization, we recommended electroconvulsive therapy (ECT). ECT was successful in treating the psychosis as well as the depressive symptoms. There was no worsening of the patient's dementia and only a slight progression in her choreiform movements. The authors question whether ECT may be of benefit in treating the psychosis of HD in the presence or absence of depressive symptoms and call for further research to determine if the use of ECT in HD patients with psychosis could prevent, or at least delay, placement in a long-term psychiatric hospital.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID