摘要:

Recent reports have challenged the assumption that unilateral and bilateral electroconvulsive therapy (ECT) are equally effective in all cases. In a prospective study, hospitalized manic patients were randomly assigned to treatment with either lithium or ECT. The first six patients received nondominant unilateral treatment but failed to respond. However, they rapidly remitted when switched to bilateral ECT. Accordingly, the next 11 manic patients to receive ECT were assigned to bilateral treatment. They were compared with the first six patients on weekly ratings of mania and other psychopathology. Both ECT groups improved but therapeutic responses were delayed until after switchover to bilateral treatment in the patients who began with unilateral ECT. We conclude that patients in the manic state should receive bilateral rather than unilateral ECT.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Prophylactic effects of atropine sulfate as a premedication for cardiac arrhythmia were studied in 44 patients receiving electroconvulsive therapy in a randomized, cross-over, double-blind design. Cardiac rhythms were recorded with Holler monitors during atropine sulfate and placebo treatments. Vagal arrhythmia seemed to be reduced with atropine sulfate premedication, but the frequency of ventricular arrhythmia was not affected.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Two raters independently assessed seizure duration in single-channel electroencephalogram (EEG) records obtained in 479 electroconvulsive treatments of 52 patients. Ratings of seizure duration were highly reliable. The measures of EEG seizure duration were substantially associated with the duration of motor manifestations, supporting the validity of the EEG determinations. Confidence ratings of the clarity of the endpoint of EEG paroxysmal activity were unrelated to the duration of seizures in EEG and motor measures. The extent to which the EEG seizure activity extended beyond the motor manifestations was strongly related to the total duration of the EEG seizure manifestations and not to the duration of motor manifestations.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Monitoring seizure length is an important addition to the clinical practice of ECT. Without monitoring, undetected missed seizures may occur. In a retrospective study of ECT treatments for a sample of 58 patients with a DSM-III diagnosis of major depression, significantly more missed seizures (p < 0.05) occurred in the elderly males.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

An overview of the use of electroconvulsive therapy (ECT) in Nigeria is presented. Unmodified ECT with bilaterally placed electrodes remains the main method of administration and is widely used for all forms of functional psychoses. ECT is used as an adjunct to chemotherapy both for inpatients and outpatients. Complications associated with the therapy are relatively few. Despite the use of unmodified ECT since 1952, there has been no report of tardive (spontaneous) seizures in patients treated by this method. In view of the widespread usage, a continuing assessment of the therapy and guidelines for its use in Nigeria seem desirable.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The combined use of lithium and electroconvulsive therapy (ECT) is currently contraindicated, due to reports of associated neurotoxicity and poor outcome. Only limited data are available to explain any pharmacological basis for an adverse interaction between the two treatments. ECT does not alter lithium distribution or kinetics. Possible drug-drug interactions between lithium and ECT premedication have been subjected to little systematic study. Despite a body of preclinical work implicating the cholinergic system in the mechanism of action of both lithium and ECT, no interaction between lithium and pre-ECT anticholinergic medication has been reported. Potentiation of barbiturate anesthetics and neuromuscular blocking agents, including succinylcholine, by lithium has been noted in the anesthesiology literature, but reports of such interaction are lacking in the context of ECT administration. Thus, no demonstrable pharmacokinetic or drug-drug interaction factors preclude combined prescription of lithium and ECT.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Electroconvulsive therapy (ECT) was successfully used to treat patients with prior neurosurgical history. The first patient had undergone surgery for a meningioma with subsequent insertion of a plate in the cranium. The second patient had a history of normal pressure hydrocephalus which was treated with a ventriculoperitoneal shunt procedure. Both patients received ECT and in both cases the presenting symptoms of depression abated. Treatment was considered both uneventful and successful.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We present the case of a patient with 80% total body surface area burned who presented for anesthesia and electroconvulsive therapy (ECT) 75 days after the injury. He was presumed to be sensitive to the K+-releasing effects of succinylcholine and therefore was given a nondepolarizing neuromuscular blocking agent, atracurium, to which he was shown to be resistant. Anesthesia for ECT on 13 occasions was without incident. Sensitivity and K+release secondary to succinylcholine is discussed as well as resistance to nondepolarizing neuromuscular blocking agents.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Present administration of electroconvulsive therapy (ECT) is safe for most patients. Succinylcholine is used and tolerated as one of several pharmacologic agents in the routine protocol. Relatively rare medical conditions, including pseudocholinesterase deficiency, cholinesterase inhibition, and severe neuromuscular disease, may complicate the use of succinylcholine. This article presents three cases in which the standard protocol was altered, using atracurium in place of succinylcholine to provide brief and well-controlled muscle relaxation. Atracurium is an alternative medication for ECT in those cases in which succinylcholine use is problematic.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We report the use of electroconvulsive therapy (ECT) for treatment of a bipolar episode in a mildly retarded young man with cerebral palsy. Difficulties in the diagnosis and treatment of affective disorders in the retarded are discussed.

ISSN:0749-8055    

出版商:OVID    

年代:1987

数据来源: OVID