Pub Date : 2024-04-08DOI: 10.1097/YCT.0000000000001012
P. Tor, Ana Rita Barreiros, Thanh Vinh Cao, V. Dong, Louise Brettell, Clara Massaneda Tuneu, Veronica Galvez, Sue Waite, S. Sarma, Grace Branjerdporn, M. Chatterton, Titus Mohan, S. Hussain, Donel Martin, Colleen Loo
{"title":"Why You Should Collect Routine Clinical Data for ECT: A Singapore Story From the CARE Network.","authors":"P. Tor, Ana Rita Barreiros, Thanh Vinh Cao, V. Dong, Louise Brettell, Clara Massaneda Tuneu, Veronica Galvez, Sue Waite, S. Sarma, Grace Branjerdporn, M. Chatterton, Titus Mohan, S. Hussain, Donel Martin, Colleen Loo","doi":"10.1097/YCT.0000000000001012","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001012","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"38 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.1097/YCT.0000000000001007
A. Tolentino, Felipe Santaella, F. M. R. Barros, L. Barnes, Osmar Della Torre, L. Schlittler, Karina Diniz Oliveira, Amilton dos Santos Júnior, Paulo Dalgalarrondo, C. E. M. Banzato
{"title":"Extreme Agitation in Mania Treated With Intravenous Continuous Infusion of Dexmedetomidine and ECT.","authors":"A. Tolentino, Felipe Santaella, F. M. R. Barros, L. Barnes, Osmar Della Torre, L. Schlittler, Karina Diniz Oliveira, Amilton dos Santos Júnior, Paulo Dalgalarrondo, C. E. M. Banzato","doi":"10.1097/YCT.0000000000001007","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001007","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"47 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1097/yct.0000000000001004
Júlia Pellizon Mazucco, S.I. Smaira, Antonio Geraldo da Silva, André R. Brunoni, José Gallucci-Neto
To identify the current treatment options for electroconvulsive therapy (ECT) therapy in public services linked to the Unified Health System in Brazil and compare them with data published in 2012 based on their availability. In this retrospective observational study, we mapped institutions that perform ECT under public health services in Brazil. A questionnaire was administered to active and inactive service centers between August 2022 and June 2023. We identified 16 institutions that performed ECT, including 12 linked to public universities and 4 with various links. In the last decade, 2 new public services that perform ECT in the country have emerged, whereas 4 services have ceased function. In 2022, the number of individuals treated with ECT per 100,000 population was 1.86, whereas the number of procedures performed per 100,000 people was 6.55. Although 2 new public ECT services have been identified, 4 have turned inactive. Most services are linked to public universities, and inactive service points to financial issues as the main factor in service interruption. Brazil has one of the lowest rates of individuals treated with ECT per 100,000 population compared with countries in North America and Europe. Thus, it is essential to raise awareness to improve ECT adoption rates and bring it out of the shadows in Brazil.
{"title":"Availability of Electroconvulsive Therapy in Public Health Services in the Last Decade in Brazil","authors":"Júlia Pellizon Mazucco, S.I. Smaira, Antonio Geraldo da Silva, André R. Brunoni, José Gallucci-Neto","doi":"10.1097/yct.0000000000001004","DOIUrl":"https://doi.org/10.1097/yct.0000000000001004","url":null,"abstract":"\u0000 \u0000 To identify the current treatment options for electroconvulsive therapy (ECT) therapy in public services linked to the Unified Health System in Brazil and compare them with data published in 2012 based on their availability.\u0000 \u0000 \u0000 \u0000 In this retrospective observational study, we mapped institutions that perform ECT under public health services in Brazil. A questionnaire was administered to active and inactive service centers between August 2022 and June 2023.\u0000 \u0000 \u0000 \u0000 We identified 16 institutions that performed ECT, including 12 linked to public universities and 4 with various links. In the last decade, 2 new public services that perform ECT in the country have emerged, whereas 4 services have ceased function. In 2022, the number of individuals treated with ECT per 100,000 population was 1.86, whereas the number of procedures performed per 100,000 people was 6.55.\u0000 \u0000 \u0000 \u0000 Although 2 new public ECT services have been identified, 4 have turned inactive. Most services are linked to public universities, and inactive service points to financial issues as the main factor in service interruption. Brazil has one of the lowest rates of individuals treated with ECT per 100,000 population compared with countries in North America and Europe. Thus, it is essential to raise awareness to improve ECT adoption rates and bring it out of the shadows in Brazil.\u0000","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"106 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1097/YCT.0000000000000628
P. Tor, Edimansyah Bin Abdin
Objectives Electroconvulsive therapy (ECT) is one of the most effective treatments for severe mood disorders and may reduce psychiatric readmissions. However, the effect on ECT on mood disorder readmissions in Asia is unclear. We embarked to assess the relationship between inpatient ECT and 1-year psychiatric readmissions for patients with mood disorders. Methods A retrospective database analysis of patients admitted to a tertiary Mood Disorders Unit in a developed Asian city was analyzed to investigate the association of inpatient ECT with psychiatric readmission using a 1-year mirror-image method with major depressive disorder and bipolar mania patients acting as their own controls. Covariates of age, sex, number of outpatient visits, and outpatient ECT were analyzed to account for confounders. t Tests were done to compare number and duration of psychiatric admissions and significance set at P < 0.05. Results Patients with major depressive disorder and bipolar mania (N = 121) receiving inpatient ECT had a 35% mean reduction from the baseline mean of number of admissions in the 1-year after ECT. Maintenance ECT (between 30 days and 1 year after discharge) was associated with the protective effect (β = −0.116, t = −2.044, P = 0.043). In major depressive disorder, there was a trend association between the number of 1-year postdischarge outpatient visits and decreased 1-year readmissions with an opposite association seen in bipolar mania. Conclusions Electroconvulsive therapy may be associated with decreased 1-year readmissions for mood disorders in Asia, and this effect may be mediated by maintenance ECT.
目的电休克治疗(ECT)是治疗严重情绪障碍最有效的方法之一，可减少精神疾病再入院率。然而，在亚洲，电痉挛疗法对情绪障碍再入院的影响尚不清楚。我们开始评估住院电痉挛疗法与情绪障碍患者1年精神病学再入院之间的关系。方法对亚洲某发达城市三级情绪障碍病房收治的患者进行回顾性数据库分析，以重度抑郁症和双相躁狂患者为对照，采用1年镜像法调查住院患者ECT与精神疾病再入院的关系。分析年龄、性别、门诊次数和门诊ECT等协变量以解释混杂因素。t检验比较精神科入院人数和持续时间，P < 0.05为显著性。结果121例重度抑郁障碍和双相狂躁患者在ECT治疗后1年内入院次数比基线平均减少35%。维持ECT(出院后30天至1年)与保护作用相关(β = - 0.116, t = - 2.044, P = 0.043)。在重度抑郁症中，出院后1年的门诊次数与1年再入院次数之间存在趋势关联，而在双相躁狂中则相反。结论电惊厥治疗可能与亚洲心境障碍患者1年内再入院率降低有关，这种作用可能是由维持电痉挛介导的。
{"title":"Mirror Readmission Study of the Association of Electroconvulsive Therapy With 1-Year Mood Disorder Readmissions in a Tertiary Mood Disorder Unit","authors":"P. Tor, Edimansyah Bin Abdin","doi":"10.1097/YCT.0000000000000628","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000628","url":null,"abstract":"Objectives Electroconvulsive therapy (ECT) is one of the most effective treatments for severe mood disorders and may reduce psychiatric readmissions. However, the effect on ECT on mood disorder readmissions in Asia is unclear. We embarked to assess the relationship between inpatient ECT and 1-year psychiatric readmissions for patients with mood disorders. Methods A retrospective database analysis of patients admitted to a tertiary Mood Disorders Unit in a developed Asian city was analyzed to investigate the association of inpatient ECT with psychiatric readmission using a 1-year mirror-image method with major depressive disorder and bipolar mania patients acting as their own controls. Covariates of age, sex, number of outpatient visits, and outpatient ECT were analyzed to account for confounders. t Tests were done to compare number and duration of psychiatric admissions and significance set at P < 0.05. Results Patients with major depressive disorder and bipolar mania (N = 121) receiving inpatient ECT had a 35% mean reduction from the baseline mean of number of admissions in the 1-year after ECT. Maintenance ECT (between 30 days and 1 year after discharge) was associated with the protective effect (β = −0.116, t = −2.044, P = 0.043). In major depressive disorder, there was a trend association between the number of 1-year postdischarge outpatient visits and decreased 1-year readmissions with an opposite association seen in bipolar mania. Conclusions Electroconvulsive therapy may be associated with decreased 1-year readmissions for mood disorders in Asia, and this effect may be mediated by maintenance ECT.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128541507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1097/YCT.0000000000000621
Stephanie Chiao, K. Isenberg, C. North
Objectives Decisions about psychotropic medication administration before electroconvulsive therapy (ECT) are central to management of a very psychiatrically ill patient population. Given that many psychotropic medications are thought to either promote or prevent seizures, there is ongoing concern about concurrent psychotropic medication and ECT administration. This study examined the effect of psychotropic medications on seizure threshold and duration during ECT stimulus titration. Methods The study sample consisted of 550 patients receiving ECT stimulus titration at a single site during a 27-month period. Systematic chart review provided clinical data, including patients' demographics, psychiatric diagnoses, medications administered in the 48 hours before ECT, and information on the ECT procedure. Referring psychiatrists were advised to discontinue lithium before ECT but otherwise managed psychotropic medications as clinically indicated. A fixed charge titration schedule was used to estimate seizure threshold. Electroconvulsive therapy motor seizure duration was estimated by the cuff method, and electroencephalogram seizure duration was estimated by review of a 2-lead strip. Results Administration of psychotropic medications, including benzodiazepines, antiepileptics, selective serotonin reuptake inhibitors, tricyclic and tetracyclic antidepressants, bupropion, and stimulants, was not associated with seizure threshold as estimated by electrical charge eliciting a generalized seizure or duration during the initial ECT titration. Tricyclic and tetracyclic antidepressant dosage was associated with seizure threshold. Conclusions Psychotropic medications may have little effect on seizure threshold and duration during titration of electrical dose at ECT initiation. Integrating this work with other literature supports making recommendations for medication discontinuation before ECT on an individual basis.
{"title":"Psychotropic Medication Effects on Seizure Threshold and Seizure Duration During Electroconvulsive Therapy Stimulus Titration","authors":"Stephanie Chiao, K. Isenberg, C. North","doi":"10.1097/YCT.0000000000000621","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000621","url":null,"abstract":"Objectives Decisions about psychotropic medication administration before electroconvulsive therapy (ECT) are central to management of a very psychiatrically ill patient population. Given that many psychotropic medications are thought to either promote or prevent seizures, there is ongoing concern about concurrent psychotropic medication and ECT administration. This study examined the effect of psychotropic medications on seizure threshold and duration during ECT stimulus titration. Methods The study sample consisted of 550 patients receiving ECT stimulus titration at a single site during a 27-month period. Systematic chart review provided clinical data, including patients' demographics, psychiatric diagnoses, medications administered in the 48 hours before ECT, and information on the ECT procedure. Referring psychiatrists were advised to discontinue lithium before ECT but otherwise managed psychotropic medications as clinically indicated. A fixed charge titration schedule was used to estimate seizure threshold. Electroconvulsive therapy motor seizure duration was estimated by the cuff method, and electroencephalogram seizure duration was estimated by review of a 2-lead strip. Results Administration of psychotropic medications, including benzodiazepines, antiepileptics, selective serotonin reuptake inhibitors, tricyclic and tetracyclic antidepressants, bupropion, and stimulants, was not associated with seizure threshold as estimated by electrical charge eliciting a generalized seizure or duration during the initial ECT titration. Tricyclic and tetracyclic antidepressant dosage was associated with seizure threshold. Conclusions Psychotropic medications may have little effect on seizure threshold and duration during titration of electrical dose at ECT initiation. Integrating this work with other literature supports making recommendations for medication discontinuation before ECT on an individual basis.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114229226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1097/YCT.0000000000000673
D. Scheepens, Damiaan Denys
T he handbook “Elektroconvulsietherapie” has 400 pages and is an up-to-datemultiauthor book for professionals. It covers state-of-the art reviews on electroconvulsive therapy (ECT). The book is almost twice as thick as the former edition (2005), indicating the growth of scientific research of ECT in the past 15 years. The 2005 edition complained about the small amount of patients treated with ECT in the Netherlands compared with other European countries. Unfortunately, in the Netherlands, in 2019, there is still a very low application rate of ECT in psychiatric disorders, even in persistent depressive disorder. The low application rate may stem from professionals' inadequate knowledge of ECT or the premature use of the handicap model in depressive disorder wherein treatment is limited to mere support. The publication of this new edition in The Netherlands comes, therefore, at the right time. In the general introduction, the authors postulate that knowledge of ECT is essential to perform this treatment adequately. The book comprises 20 chapters which are logically divided into 3 sections: clinical aspects, research aspects, and social aspects. The clinical-scientific section consists of 8 chapters: indications and efficacy of mood disorders, indications and efficacy in other disorders, side-effects, high-risk patients, comorbidity, and there are 4 chapters about the practical aspects of the treatment. The literature in the chapters about indications iswell summarized. Chapter 3 covers the side effects. Chapter 4 describes the practical aspects and anesthesia for ECT and offers an extensive flow diagram for pre-ECTassessment of patients with cardiovascular risk or cerebrovascular condition. The ECT session itself is described point by point and provides a good guideline for ECT centers. The next chapters review literature regarding high-risk patients and describe the more practical aspects of ECT. The second section deals with the scientific aspects of ECTand is divided into 7 chapters. The chapters cover electricity theory, anatomy, and neurophysiology of ECT, electroencephalography, and clinical and
{"title":"Review Leerboek Elektroconvulsietherapie: Editors: Verwey, B, van Waarde J. Uitgeverij Boom|de Tijdstroom","authors":"D. Scheepens, Damiaan Denys","doi":"10.1097/YCT.0000000000000673","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000673","url":null,"abstract":"T he handbook “Elektroconvulsietherapie” has 400 pages and is an up-to-datemultiauthor book for professionals. It covers state-of-the art reviews on electroconvulsive therapy (ECT). The book is almost twice as thick as the former edition (2005), indicating the growth of scientific research of ECT in the past 15 years. The 2005 edition complained about the small amount of patients treated with ECT in the Netherlands compared with other European countries. Unfortunately, in the Netherlands, in 2019, there is still a very low application rate of ECT in psychiatric disorders, even in persistent depressive disorder. The low application rate may stem from professionals' inadequate knowledge of ECT or the premature use of the handicap model in depressive disorder wherein treatment is limited to mere support. The publication of this new edition in The Netherlands comes, therefore, at the right time. In the general introduction, the authors postulate that knowledge of ECT is essential to perform this treatment adequately. The book comprises 20 chapters which are logically divided into 3 sections: clinical aspects, research aspects, and social aspects. The clinical-scientific section consists of 8 chapters: indications and efficacy of mood disorders, indications and efficacy in other disorders, side-effects, high-risk patients, comorbidity, and there are 4 chapters about the practical aspects of the treatment. The literature in the chapters about indications iswell summarized. Chapter 3 covers the side effects. Chapter 4 describes the practical aspects and anesthesia for ECT and offers an extensive flow diagram for pre-ECTassessment of patients with cardiovascular risk or cerebrovascular condition. The ECT session itself is described point by point and provides a good guideline for ECT centers. The next chapters review literature regarding high-risk patients and describe the more practical aspects of ECT. The second section deals with the scientific aspects of ECTand is divided into 7 chapters. The chapters cover electricity theory, anatomy, and neurophysiology of ECT, electroencephalography, and clinical and","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121921211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1097/YCT.0000000000000625
G. Rakesh, N. Mischel, B. Luber, R. Keefe, S. Emory, S. Lisanby, S. Szabo
S chizophrenia is a psychiatric illness with a prevalence of 1.4 to 1.6 per 1000 persons in the United States. Studies show the prevalence of cognitive deficits in patients with schizophrenia, spanning multiple domains, such as working memory, processing speed, and verbal memory. Treatment modalities that have tried to address cognitive deficits in schizophrenia include medications, cognitive remediation, and cognitive behavioral therapy with limited success. The lack of treatments for cognitive deficits has led to the investigation of other possible interventions, such as noninvasive brain stimulation. Systematic reviews have shown that transcranialmagnetic stimulation (TMS) may be efficacious in remediating cognitive deficits in schizophrenia. A recently developed and potentially quite promising form of TMS, called theta burst stimulation (TBS), applies short bursts of TMS (typically 3 pulses) at 50 Hz (within the gamma range of endogenous brain oscillations). These short bursts occur every 200milliseconds, or at 5 Hz, which iswithin the theta oscillation range. Theta burst stimulation is more potent when compared with conventional repetitive TMS. Trials have shown utility for high-frequency TMS in ameliorating positive and negative symptoms in schizophrenia. We recruited 6 patients (4 inpatients and 2 outpatients) to apply one session of excitatory TBS (iTBS) stimulating the left dorsolateral prefrontal cortex (DLPFC), performing Positive and Negative Symptom Scale (PANSS) and Brief Assessment of Cognition in Schizophrenia (BACS) test battery at baseline before stimulation. Three of 6 patients completed iTBS session. Subjects
{"title":"Theta Burst for Cognitive Remediation in Schizophrenia: A Case Series and Feasibility Study.","authors":"G. Rakesh, N. Mischel, B. Luber, R. Keefe, S. Emory, S. Lisanby, S. Szabo","doi":"10.1097/YCT.0000000000000625","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000625","url":null,"abstract":"S chizophrenia is a psychiatric illness with a prevalence of 1.4 to 1.6 per 1000 persons in the United States. Studies show the prevalence of cognitive deficits in patients with schizophrenia, spanning multiple domains, such as working memory, processing speed, and verbal memory. Treatment modalities that have tried to address cognitive deficits in schizophrenia include medications, cognitive remediation, and cognitive behavioral therapy with limited success. The lack of treatments for cognitive deficits has led to the investigation of other possible interventions, such as noninvasive brain stimulation. Systematic reviews have shown that transcranialmagnetic stimulation (TMS) may be efficacious in remediating cognitive deficits in schizophrenia. A recently developed and potentially quite promising form of TMS, called theta burst stimulation (TBS), applies short bursts of TMS (typically 3 pulses) at 50 Hz (within the gamma range of endogenous brain oscillations). These short bursts occur every 200milliseconds, or at 5 Hz, which iswithin the theta oscillation range. Theta burst stimulation is more potent when compared with conventional repetitive TMS. Trials have shown utility for high-frequency TMS in ameliorating positive and negative symptoms in schizophrenia. We recruited 6 patients (4 inpatients and 2 outpatients) to apply one session of excitatory TBS (iTBS) stimulating the left dorsolateral prefrontal cortex (DLPFC), performing Positive and Negative Symptom Scale (PANSS) and Brief Assessment of Cognition in Schizophrenia (BACS) test battery at baseline before stimulation. Three of 6 patients completed iTBS session. Subjects","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"33 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116364209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1097/YCT.0000000000000627
L. Volkaerts, Rick Roels, F. Bouckaert
In patients with a deep brain stimulator (DBS), electroconvulsive therapy (ECT) has proven to be a safe and effective treatment option after several medication failures in major depression, especially in the presence of psychotic symptoms. Electroconvulsive therapy has also proven to be effective in the treatment of Parkinson's disease (PD). To date, there have been no reports on the effect of ECT on motor function in PD patients with a functioning DBS. We present the case of a woman with DBS as a treatment for PD, safely treated with ECT for a psychotic depression. Depression severity and motor changes were evaluated on a weekly basis using the Montgomery-Åsberg Depression Rating Scale and the Unified Parkinson's Disease Rating Scale. During the course of ECT, the Montgomery-Åsberg Depression Rating Scale score declined from 34 to 13, and the Unified Parkinson's Disease Rating Scale motor score from 44 to 12 with positive impact on rigidity. Considering the positive impact of ECT on the motor function in our patient, new research should look into ECT as an augmentation strategy in motor dysfunction in patients treated with DBS for PD.
{"title":"Motor Function Improvement After Electroconvulsive Therapy in a Parkinson's Disease Patient With Deep Brain Stimulator.","authors":"L. Volkaerts, Rick Roels, F. Bouckaert","doi":"10.1097/YCT.0000000000000627","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000627","url":null,"abstract":"In patients with a deep brain stimulator (DBS), electroconvulsive therapy (ECT) has proven to be a safe and effective treatment option after several medication failures in major depression, especially in the presence of psychotic symptoms. Electroconvulsive therapy has also proven to be effective in the treatment of Parkinson's disease (PD). To date, there have been no reports on the effect of ECT on motor function in PD patients with a functioning DBS. We present the case of a woman with DBS as a treatment for PD, safely treated with ECT for a psychotic depression. Depression severity and motor changes were evaluated on a weekly basis using the Montgomery-Åsberg Depression Rating Scale and the Unified Parkinson's Disease Rating Scale. During the course of ECT, the Montgomery-Åsberg Depression Rating Scale score declined from 34 to 13, and the Unified Parkinson's Disease Rating Scale motor score from 44 to 12 with positive impact on rigidity. Considering the positive impact of ECT on the motor function in our patient, new research should look into ECT as an augmentation strategy in motor dysfunction in patients treated with DBS for PD.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125101203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1097/yct.0000000000000645
P. Rosenquist, Emily Carbaugh
{"title":"Brain Stimulation for Clinicians. Second Edition","authors":"P. Rosenquist, Emily Carbaugh","doi":"10.1097/yct.0000000000000645","DOIUrl":"https://doi.org/10.1097/yct.0000000000000645","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127297354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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