A 20 Year Practice Review of Electroconvulsive Therapy for Adolescents

Puffer, Chad C; Wall, Christopher A.; Huxsahl, John E.; Frye, Mark A.

doi:10.1089/cap.2015.0139

Cited by 65 publications

(50 citation statements)

References 19 publications

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“…ECT is an accepted treatment for TRD in adult patients and can be currently considered an alternative treatment also in depressed adolescents with severe suicide risk and/or TRD (Puffer et al, ). However, there is limited data on the safety and efficacy of ECT for depression in patients with EDs, and even more limited data on ECT in adolescents with EDs and combined depression.…”

Section: Discussionmentioning

confidence: 99%

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Shilton

Enoch‐Levy

Giron

et al. 2019

Intl J Eating Disorders

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Objective Major depressive disorder (MDD) is common in anorexia nervosa (AN), associated with worse outcome and greater suicide risk. Electroconvulsive therapy (ECT) is highly effective in the treatment of MDD refractory to antidepressive treatment. We describe a case series of female adolescents with AN receiving ECT for MDD resistant to treatment and/or with severe suicide risk. Method We retrospectively analyzed the files of all 30 adolescent females hospitalized in our department because of AN between 1998 and 2017 and treated with ECT. Severity of eating disorder (ED) and depressive symptoms was retrospectively assessed using the Clinical Global Impression‐Severity Scale. Results Patients were severely depressed and suicidal on admission. All were resistant to antidepressants. A significant deterioration in depression, with severe suicidality, occurred from admission to pre‐ECT, with concomitant improvement in ED symptoms and increase in body mass index (BMI). Significant improvement in depressive and ED symptoms and increase in BMI occurred following ECT, continuing to discharge. Adverse effects were mostly minimal. Fifty‐three percentage of the patients were rehospitalized within the first year after ECT, mostly because of deterioration of depression and attempted suicide. Several years after discharge, 46.6% of the patients had no evidence of depression, suicidality, and ED‐symptomatology, and another 23% had only evidence of ED symptomatology. Discussion ECT is safe and well tolerated in AN with severe comorbid treatment resistant MDD and/or with increased suicide risk. Many AN patients undergoing ECT may be remitted at long‐term follow‐up.

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Section: Discussionmentioning

confidence: 99%

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Shilton

Enoch‐Levy

Giron

et al. 2019

Intl J Eating Disorders

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“…Though cognitive impairment is often cited as an adverse effect of ECT, published data to date has not supported this concern. In fact, some studies have documented cognitive improvement after ECT (Ghaziuddin et al, 2011; Puffer et al, 2016). Minor side effects include headache, nausea, vomiting, muscle aches, post‐anesthesia confusion, and/or agitation.…”

Section: Are There Side Effects?mentioning

confidence: 99%

“…While maintenance ECT has been well‐documented in adults, there are only a few published case reports of ECT use as maintenance therapy in adolescents. While psychopharmacology may be difficult in a patient with a history of intractable illness, data demonstrates that ECT use results in decrease in polypharmacy post‐ECT treatment (Puffer et al, 2016). For example, atypical antipsychotics, medications associated with long‐term risks such as metabolic syndrome, were the most common type of medications prescribed pre‐ECT.…”

Section: My Patient Has Completed Ect Treatments Now What?mentioning

confidence: 99%

“…For example, atypical antipsychotics, medications associated with long‐term risks such as metabolic syndrome, were the most common type of medications prescribed pre‐ECT. In this study, 62% of patients were prescribed one or two fewer medications once ECT treatment was completed (Puffer et al, 2016).…”

Section: My Patient Has Completed Ect Treatments Now What?mentioning

confidence: 99%

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Electroconvulsive therapy: A review

Parker¹,

Hunt²

2019

Child Adolescent Behavior

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Electroconvulsive therapy, or ECT, is an effective treatment for severe, persistent neuropsychiatric disorders, including mood disorders, acute suicidality, catatonia, neuroleptic malignant syndrome, and, to a lesser extent, schizophrenia. ECT is generally reserved for adults, but adolescents with “treatment‐resistant” conditions, defined as failure of two or more adequate medication trials, also benefit. Studies show that the majority of child and adolescent psychiatrists lack the necessary training to administer ECT. What's more, ECT is often represented inaccurately and negatively in popular media, resulting in controversial public opinion and increased stigmatization. Despite nearly 70 years of evidence supporting the efficacy and safety of ECT, including 2004 American Academy of Child and Adolescent Psychiatry (AACAP) guidelines for ECT use in adolescents and an ethical review of this intervention, ECT continues to be underutilized. The aim of this article is to dispel myths about ECT by providing evidence‐based psychoeducation, a review of the indications and when providers should consider a referral.

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“…Die zweitgrößte Kohorte beschrieben im Jahre 2016 Puffer et al [29]. Von 1991 bis 2013 wurden in einem tertiären Medizinzentrum in Minneapolis 51 Jugendliche, darunter 30 Mädchen, im Mittel 9-mal elektrokonvulsiv behandelt.…”

Section: Introductionunclassified

Elektrokonvulsionstherapie – bei Kindern und Jugendlichen mit Schizophrenie wirksam und gut verträglich

Weirich

Reinhardt

Buchmann

et al. 2020

Fortschr Neurol Psychiatr

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ZusammenfassungWir berichten über vier Patienten im Alter von 12 bis 17 Jahren mit schizophrenen Psychosen, zwei davon mit katatoner Symptomatik, die erfolgreich und sicher mit Elektrokonvulsionstherapie (EKT) behandelt wurden. Unter einer kombinierten Therapie aus EKT und entweder Ziprasidon oder Clozapin verbesserte sich der Zustand aller Patienten erheblich. Schweregrad und Verlauf der akuten Schizophrenie wurden mit der Brief Psychiatric Rating Scale (BPRS) evaluiert. Schweregrad und Verlauf der Katatonie wurden mit der Bush-Francis Catatonia Rating Scale (BFCRS) gemessen. Die Fälle bestätigen frühere Berichte zur Wirksamkeit, zur Sicherheit und Verträglichkeit von EKT bei der Behandlung von Kindern und Jugendlichen mit Schizophrenie.

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A 20 Year Practice Review of Electroconvulsive Therapy for Adolescents

Abstract: This report describes the largest group of adolescents receiving ECT since 1947, and supports ECT as a safe and effective modality for most treatment-recalcitrant psychiatric illness in youth.

Cited by 65 publications

References 19 publications

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Electroconvulsive therapy: A review

Elektrokonvulsionstherapie – bei Kindern und Jugendlichen mit Schizophrenie wirksam und gut verträglich

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