ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A retrospective study was conducted of 14 affectively ill patients who were treated with long-term unilateral maintenance electroconvulsive therapy (MECT). The patients had received an inpatient course of ECT before being referred for MECT. The average age was 57 ± 16 years (range 30–91). The average interval between inpatient ECT was 2.4 ± 0.9 days, in contrast to the interval between MECT, which was 12.1 ± 11.3 days. The average time to start MECT after inpatient ECT was 16.2 ± 16.2 days. The average duration of MECT was 81 ± 104 days (maximum 571). Patients' affective symptoms continued to improve during the course of MECT based on Carroll Depression Ratings. Adjustment of the electrical dose and caffeine augmentation were used to keep the seizure durations >30 s by electroencephalograph (EEG) monitoring. Over time, most treatments were administered using the maximal charge provided by the Mecta SR-1. Despite considerable time intervals between MECT treatments, seizure durations did not increase. Additionally, high stimulus charge and frequently administered caffeine were used to maintain seizure length. The apparent anticonvulsant effect of ECT was not lost over the time span of MECT. This has clinical implications if the anticonvulsant effects of ECT contribute to determining the clinical response.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Blood pressure changes recorded during electroconvulsive therapy (ECT) in 23 psychiatric in-patients with major depressive disorders correlated with and predicted the degree of anterograde memory changes measured 48–72 h after ECT. The Randt memory test was the principal measure of memory change. A subgroup of older patients with cardiovascular illness received trimethaphan, a ganglionic blocker that impedes a hypertensive surge during the treatment. They did not differ in memory function from a younger subgroup that did not receive trimethaphan. Control of the hypertensive response in the older age group counterbalanced the additional memory dysfunction that was anticipated as a result of advanced age and cardiovascular pathology.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study was undertaken to examine the effect of stimulus energy on electroconvulsive therapy (ECT)-induced prolactin (PRL) release. Patients undergoing a course of right unilateral or bilateral ECT were studied during two consecutive treatments. The order of high- and low-energy ECT was counterbalanced between the two treatments. A multivariate repeated-measures analysis of variance with seizure duration within each condition (high/low energy ECT) used as a covariate showed that seizure duration was not significantly different between conditions, but was significantly related to PRL release. However, PRL increase in response to high-energy ECT was significantly higher compared with low-energy ECT. These results indicate that in addition to the previously demonstrated relationship between electrode placement and ECT-induced PRL response, PRL release also varies as a function of stimulus energy. The implications of the hypothesis that this neuroendocrine response could serve as an indication that an effective stimulus has been delivered are discussed.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We used the Randt Memory Test (RMT) to examine the effects of electroconvulsive therapy (ECT) on memory in 23 depressed patients. Immediate recall was unaffected by ECT, but delayed recall was reduced 48–72 h following reorientation after ECT. These changes were not correlated with the total seizure time or with the dose of electrical energy. Most patients rated their memory as improved after ECT on the Squire Subjective Memory Questionnaire. Improvement in mood, as reflected in behavior scales, was correlated with the subjective perception of memory performance, but not with the objective performance on the RMT. Improvement in depressive mood is independent of changes in performance on tests of memory. The RMT is a convenient and useful instrument to monitor the memory effects of ECT.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We examined the relation between age and recovery of memory functions after electroconvulsive therapy (ECT). In a group of patients 20–65 years of age, older depressed patients treated with ECT experienced more severe and longer lasting memory deficits than did younger patients. Testing conducted 24–72 h after a course of ECT showed more severe deficits in older patients for verbal and visuospatial anterograde memory, and for retrograde memory. The difference between younger and older subjects was marginal at 1 month follow-up, seen only in differences in verbal anterograde memory. At 6 months follow-up, no difference in memory test scores between older and younger patients was observed. Older patients are more vulnerable to cognitive effects of ECT, and these effects last longer.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A 30-year-old man with a personal and family history of malignant hyperthermia and a 7-year history of psychiatric illness unresponsive to various psychotropic medications benefitted from electroconvulsive therapy given in combination with clozapine. Volatile inhalation anesthetics and a depolarizing muscle relaxant (succinylcholine) were assiduously avoided. Dantrolene was administered intravenously before the first treatment but was not used for the remainder of the treatments. Anesthesia was induced with methohexital and atracurium. The treatment course was uneventful.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A duration of 25–30 s of convulsions in electroconvulsive therapy (ECT) is thought to be the minimum necessary for an adequate treatment. We describe three manic attacks in a 48-year-old patient resistant to psychotropic drugs who responded to successive courses of ECT, each with unusually short durations of seizures.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

It is often recommended that lithium not be prescribed during electroconvulsive therapy (ECT). The combined use of these treatments has been considered a risk factor for inducing encephalopathy; however, this precaution is controversial. We report the case of a woman who received over 70 outpatient maintenance ECT concurrently with lithium for years without signs of confusion. Similar observations are reported by others, too. The relative merits of all therapeutic interventions should be individualized to each patient.

ISSN:0749-8055    

出版商:OVID    

年代:1993

数据来源: OVID