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PubMed1981

Electric convulsion therapy in depression: a double-blind controlled trial.

The therapeutic effect of simulated and real bilateral electric convulsion therapy was examined in a double-blind, randomised trial on 22 patients with a primary depressive illness. Each treatment was given twice weekly for three weeks and the results assessed by the psychiatrist using a visual analogue rating scale, nurses using a nine-point rating scale, and the patients themselves using the Beck Depression Inventory. With all three methods of assessment patients given the real treatment substantially improved (p less than 0.001), whereas those given simulated treatment showed little change. Three weeks after substituting real treatment for simulated, however, these patients were also significantly improved (psychiatrist's rating p less than 0.001; nurses' rating p less than 0.005; Beck inventory p less than 0.005). These findings confirm the value of electric convulsion therapy in severe depressive illness and strongly suggest that the convulsion is important for the therapeutic effect.

Clinical Trials as Topic↗

PubMed1999

A fractured hip during electro-convulsive therapy.

Bone injury while undergoing electro-convulsive therapy is thought to be rare. We report a case of hip fracture during treatment which was associated with osteoporosis. Patients at increased risk could be identified.

Aged↗

PubMed1977

Memory impairment after convulsive therapy. Influence of age and number of treatments.

The influence of age and number of treatments on memory impairment was studied in depressed patients after a series of convulsive treatments: bilateral ECT, unilateral ECT on the nondominant hemisphere, and fluorothyl convulsive therapy. Before and after the completed convulsive therapy course the patients were tested with a memory test battery and the symptoms rated with a depression scale. Before treatment older age-groups had decreased ability to learn, but their post-treatment forgetting score was not significantly higher than in other age-groups. An increase in the number of ECTs did not seem to correlate with the degree of memory impairment. The conclusion of the present study is that age (up to 65) and the number of ECTs (up to 10) have no apparent influence on memory impairment after electroconvulsive therapy.

Adolescent↗

PubMedDate not supplied

Anesthesiologic considerations in psychiatric convulsive therapy.

The authors, drawing from their very large experience, describe technics of administering anesthesia and muscle-relaxing agents for convulsive therapy. After a brief historical review, they mention in detail the materials used and the set up for this modified electroconvulsive treatment. They describe the signs of amnesia and those of muscular relaxation in order to administer a modified electroconvulsive treatment properly. A comparison of this modification with various other methods used in different centers is made. A section of the paper is devoted to the less common use of Indoklon. Contraindications for the various therapeutic methods are mentioned and a critical evaluation is provided. The authors draw conclusions from their clinical experience and give the results of their observations. The management of various side-effects and possible complications is discussed. The article should be considered as a guide in the use of modified convulsive therapy.

Amnesia↗

PubMed2001

Convulsive therapy: a review of the first 55 years.

Convulsive therapy was introduced to psychiatric practice in 1934. It was widely hailed as an effective treatment for schizophrenia and quickly recognized as equally effective for the affective disorders. Like other somatic treatments, it was replaced by psychotropic drugs introduced in the 1950s and 1960s. But two decades later, ECT was recalled to treat pharmacotherapy-resistant cases. Avid searches to optimize seizure induction and treatment courses, to reduce risks and fears, to broaden the indications for its use, and to understand its mechanism of action followed. Unlike other medical treatments, however, these searches were severely impeded by a vigorous antipsychiatry movement among the public and within the profession. ECT is effective in the treatment of patients with major depression, delusional depression, bipolar disorder, schizophrenia, catatonia, neuroleptic malignant syndrome, and parkinsonism, and this breadth of action is both remarkable and unique. ECT is a safe treatment. No age or systemic condition bars its use. Its major limitations are the high relapse rates and the occasional profound effects on memory and recall that mar its success. Experiments to sustain its benefits with medications and with continuation ECT are underway. Its mode of action remains a mystery and this puzzle is an unappreciated challenge. The full impact of this intervention is yet to be felt.

Electroconvulsive Therapy↗

PubMed2000

Febrile convulsions: acute seizure characteristics and anti-convulsant therapy.

A descriptive study using data from the medical records of 448 children with febrile convulsion was carried out to determine the seizure characteristics and use of anti-convulsant therapy for febrile convulsions in a Malaysian hospital. There was a higher incidence of multiple seizures and a lower incidence of focal seizures in the local population than in studies done among Western populations. The majority of initial seizures occurred within 24 h of fever onset. Transient neurological abnormalities following an acute seizure were common. A quarter of children referred by general practitioners had been given anti-convulsants prior to referral but up to 20% of general practitioners had used ineffective routes for administering diazepam. However, diazepam used in the hospital was found to be effective in controlling acute febrile seizures.

Acute Disease↗

PubMed2000

Comparison of thiopentone sodium and propofol for electro convulsive therapy (ECT).

OBJECTIVE: For safe conduct of electro convulsive therapy (ECT), general anaesthesia is administered to the patients. In this study we compared thiopentone sodium and propofol as induction agents for ECT. PATIENTS AND METHODS: Twenty five patients each undergoing at least 2 sessions of ECT at the psychiatry department were included in the study. Each patient either received thiopentone or propofol for induction of sleep in a randomized manner. Drugs were evaluated regarding their effects on ECT induced haemodynamic changes (Blood pressure, Heart rate), seizure duration related to the procedure and recovery from sleep. Any side effects during the procedure and recovery were also noted. RESULTS: Propofol offered a superior haemodynamic stability during the procedure and a quick recovery from sleep. CONCLUSION: Propofol was found to be a better induction agent for ECT compared to thiopentone sodium.

Adult↗

PubMed1985

Convulsive Therapy: Fifty Years of Progress.

The origins of convulsive therapy, its early developments, present practice, central elements of the treatment, and neurohumoral and neuroendocrine theories of its antidepressant action are reviewed on the 50th anniversary of its introduction.

Journal Article↗

PubMed1990

[A reduced variant of convulsive therapy with ammonium chloride in patients with neurotic depression].

Results of ammonium convulsive therapy (ACT) in 203 patients with neurotic depressive states of various nosological origin are presented. In the total population subjected to 4-20 sessions of ACT, a full recovery or a good remission were attained in 89% of patients. The remission starts after 2 to 4 sessions with the improvement of basic mood and reducing of anxiety. Later continuous activation of the behavior may be seen. The best results were attained in patients with depressive, hypochondriac and neurasthenic neuroses, especially when astheno-, anxious-depressive or astheno-hypochondriac syndromes predominated. ACT is well tolerated by patients with no marked side effects. ACT can be recommended as a safe and effective treatment method in patients with moderate depression.

Adult↗

PubMed1985

Electric Acupuncture Convulsive Therapy.

In 150 schizophrenic patients, a comparative investigation between electric acupuncture convulsive therapy (EACT) and electroconvulsive therapy (ECT) showed that the current used for eliciting a convulsion in EACT was only 3.6% of that for ECT when the electrodes were placed at acupoints Baihui and Renzhong. EACT is a modification of ECT in which stimulating currents are passed through acupuncture needle electrodes inserted in midline positions. In this study, the efficacy of EACT was better, the somatic and visceral reactions milder, and the incidence of spine fracture and changes in EEG and in memory were less than in ECT. The clinical efficacy of electroconvulsive therapy is seen to depend on changes in midline brain structures.

Journal Article↗

PubMed1950