Decreasing Adverse Outcomes of Unmodified Electroconvulsive Therapy: Suggestions and Possibilities

  title={Decreasing Adverse Outcomes of Unmodified Electroconvulsive Therapy: Suggestions and Possibilities},
  author={Jes{\'u}s Gallegos and Punit V Vaidya and Douglas D'Agati and Geetha Jayaram and Thai Nguyen and Adarsh Tripathi and Jitendra kumar Trivedi and Irving M Reti},
  journal={The Journal of ECT},
Abstract Electroconvulsive therapy (ECT) is far and away the most effective treatment for depression and quite effective for a range of other psychiatric conditions that are unresponsive to medication. Electroconvulsive therapy in the developed world has been administered with anesthesia, muscle relaxants, and ventilation since the mid-1950s following 20 years of unmodified treatment. However, in much of the developing world, ECT continues to be administered unmodified because of lack of… 
Electroconvulsive therapy pre-treatment with low dose propofol: comparison with unmodified treatment.
Right Unilateral Versus Bilateral Electroconvulsive Therapy in Patients With Clinical Depression
There was no significant difference between the efficacy of bilateral and unilateral placements of electrodes in electroconvulsive therapy (p=0.116), and the right unilateral ECT was equally effective in improving the depressive symptoms (p<0.0001).
ECT-Related Anxiety: A Systematic Review
Electroconvulsive therapy–related anxiety is a highly prevalent phenomenon, and the literature provides little guidance for its clinical management.
Predictors of electroconvulsive therapy postictal delirium.
The effects of modified brief pulse bilateral electroconvulsive therapy (ECT) on disease profile and cognitive functions in patients of Depression, Mania and Schizophrenia
Title: The effects of modified brief pulse bilateral electroconvulsive therapy (ECT) on disease profile and cognitive functions in patients of Depression, Mania and Schizophrenia. Aims & Objectives:
Neuroplasticity hypothesis of the mechanism of electroconvulsive therapy: A proton magnetic resonance and functional connectivity investigation
This work examined studies of functional connectivity and metabolite changes in major depressive disorder patients who are considered treatment resistant and found that the seizure likely has broad effect that somehow corrects the underlying dysfunction in brain circuitry.
Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China.
The patients receiving ECT for the first time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID.
Cross-cultural Comparison of Perceptions and Knowledge About Electroconvulsive Therapy Among Adults Who Screened Positive for Depression in the United States, India, and China
Greater public education is needed about ECT, particularly in the United States, because misperceptions and lack of knowledge may hinder utilization of ECT in India, China, and the United United States.
Commentary on Performance Improvement: One Psychiatry Department's Experience.
Patient Safety in Psychiatry: One Department’s Experience In the last decade, the burdens of selfgovernance for physicians have greatly increased to include performance initiatives, revenue


The Practice of Electroconvulsive Therapy in Malawi
Unmodified ECT in Malawi is an effective treatment with less severe side effects than commonly thought and efforts to improve treatment standards are undertaken.
The Safety and Efficacy of Benzodiazepine-Modified Treatments as a Special Form of Unmodified ECT
If ECT is urgently indicated but anesthesia and hence conventional muscle relaxants cannot be administered, benzodiazepine-modified ECT may be a safer alternative to un modified ECT, and merits wide attention because of its public health importance in countries with poor medical infrastructure.
Unmodified Electroconvulsive Therapy: The Perspective of Patients From a Developing Country
Unmodified ECT is fairly well accepted among patients, although a majority complained of deficiencies in information provided about and consent toward the procedure.
Variations on a theme of unmodified electroconvulsive therapy: science or heresy?
In a small, prospective study of 50 consecutive patients who received a course of 6 unmodified electroconvulsive therapy (ECT) treatments, routine radiological assessments identified only 1 patient to have experienced a (minor, subclinical) vertebral fracture, suggesting that even if unmodified ECT is associated with musculoskeletal risks, the risks are subclinical and not as large as historically recorded.
Effects of General Anesthetic Agents in Adults Receiving Electroconvulsive Therapy: A Systematic Review
All of the available induction agents in this review would be appropriate for ECT and when the clinician needs to prolong seizure length, methohexital or the addition of a short-acting opioid to metho hexital or propofol should be considered.
Propofol and Methohexital as Anesthetic Agents for Electroconvulsive Therapy: A Randomized, Double-Blind Comparison of Electroconvulsive Therapy Seizure Quality, Therapeutic Efficacy, and Cognitive Performance
Propofol is a safe and efficacious anesthetic for ECT treatment and detected a tendency toward improved cognitive performance after anesthesia with propofol as compared with methohexital, but with statistical significance in only 2 cognition trials.
The Comparative Effects of Methohexital, Propofol, and Etomidate for Electroconvulsive Therapy
Etomidate may be a useful alternative to propofol and methohexital for ECT therapy and recovery of cognitive functions was prolonged after etomidate because of the longer period of seizure activity.
Naturalistic comparative study of outcome and cognitive effects of unmodified electro-convulsive therapy in schizophrenia, mania and severe depression in Nigeria.
Unmodified ECT combined with pharmacotherapy was safe and effective with non-enduring subjective memory difficulty for this potentially drug treatment resistant group of psychotic patients.
Anesthesia for electroconvulsive therapy: effects of propofol and methohexital on seizure activity and recovery.
Compared with methohexital, the use of propofol was associated with a clinically insignificant decrease in seizure duration, however, prop ofol wasassociated with improved hemodynamic stability and an earlier return of cognitive function after ECT.
Electroconvulsive therapy: a review of the literature.
The following article reviews the current literature on the administration and effectiveness of ECT, highlighting some of the main points of contention in the debate over its use.