Can ECT-induced cognitive effects be altered pharmacologically?

Khan, Arifulla; Mirolo, M. H.; Mirolo, Hugh A.; Miller, Sheree A.

doi:10.1016/0278-5846(93)90016-l

Cited by 14 publications

(4 citation statements)

References 41 publications

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“…Other theories focus on ECT's effects on brain metabolism and neurochemistry: breach of the blood-brain barrier and increased cerebral blood pressure (Bolwig et al, 1977;Taylor et al, 1985); regional increases in T2 relaxation times (Diehl et al, 1994); disturbance of the long-term potentiation mechanism (Sackeim, 2000;Rami-Gonzalez et al, 2001); excessive release of excitatory amino acids and activation of their receptors (Chamberlin & Tsai, 1998;Rami-Gonzalez et al, 2001), and decreased cholinergic transmission (Khan et al, 1993;RamiGonzalez et al, 2001). Even temporary alterations in any of these may have permanent effects on the brain.…”

Section: Possible Mechanisms Of Actionmentioning

confidence: 99%

Memory and cognitive effects of ECT: informing and assessing patients^†

Robertson¹,

Pryor²

2006

Adv. psychiatr. treat

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Over the past few years electroconvulsive therapy (ECT) has come under increased scrutiny in the UK, with the first systematic review of patients' experiences and new national guidelines. Our aim in this article is to translate recent and sometimes confusing research and policy statements into practical guidance that benefits patients. We examined the evidence on the permanent memory and cognitive effects of ECT, with a focus on delineating their nature, understanding how ECT may cause them, informing prospective patients about them, and assessing their impact on former patients. We describe a simple and effective method for assessing retrograde amnesia. Data do not exist at this time to confirm the mechanisms by which ECT exerts its adverse effects, but clinicians should fully inform patients of the possible permanent adverse effects of the treatment, which include amnesia, memory disability and cognitive disability, and should provide follow-up testing using relevant instruments.

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Section: Possible Mechanisms Of Actionmentioning

confidence: 99%

Memory and cognitive effects of ECT: informing and assessing patients^†

Robertson¹,

Pryor²

2006

Adv. psychiatr. treat

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“…They argued that changes in electrochemical levels, abnormal functioning of the long-term potentiation process, and decreased cholinergic transmission contribute to transient memory deficits and incapacity in obtaining new information-after ECT [ 34 ]. An excessive release of excitatory amino acids and activation of their receptors (leading to oxidative stress) [ 35 ] as well as reduction in cholinergic transmission in the central nervous system [ 36 ], all of which are associated with ECT (particularly seizures), lead to adverse effects on cognitive functions. ECT causes a massive release of gamma-aminobutyric acid neurotransmitters and inhibits the activity of the cerebral cholinergic system [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Side Effects of Mixed-Strategy Electroconvulsive Therapy: A Proof-of-Concept Randomized Clinical Trial on Late Life Depression

Lv,

Sun,

Chen

et al. 2024

Psychiatry Investig

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Objective Patients with late life depression sometimes refuse to receive electroconvulsive therapy (ECT) owing to its adverse reactions. To alleviate patient’s resistance, a novel ECT stimulation strategy named mixed-strategy ECT (msECT) was designed in which patients are administered conventional ECT during the first three sessions, followed by low energy stimulation during the subsequent sessions. However, whether low energy electrical stimulation in the subsequent stage of therapy affect its efficacy and reduce adverse reactions in patients with late life depression remains unknown. To explore differences between msECT and regular ECT(RECT) with respect to clinical efficacy and side effectsMethods This randomized, controlled trial was conducted from 2019 to 2021 on 60 patients with late life depression who were randomly assigned to two groups: RECT or msECT. A generalized estimating equation (GEE) was used to compare the two stimulation strategies regarding their efficacy and side effects on cognition. Chi-squared test was used to compare side effects in the two strategies.Results In the intent-to-treat group, the GEE model suggested no differences between-group difference in Hamilton Depression Rating Scale-17 score over time (Wald χ2=7.275, p=0.064), whereas the comparison of side effects in the two strategies favored msECT (Wald χ2=8.463, p=0.015) as fewer patients had adverse events during the second phase of treatment with msECT (χ2 =13.467, p=0.004).Conclusion msECT presents its similar efficacy to RECT. msECT may have milder side effects on cognition.

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“…Potential neurobiological mechanisms in cognitive side effects of ECT There are some animal and human preliminary evi dences on the role of neurotransmitters/biologi cal alterations with the adverse cognitive effect of ECT [33,34]. The investigated systematic alterations include cholinergic, endogenous opioid, glucocorti coid and glutaminergic systems, which were mostly conducted in animal models [34][35][36][37].…”

Section: Neuroleptic Malignant Syndromementioning

confidence: 98%

“…The investigated systematic alterations include cholinergic, endogenous opioid, glucocorti coid and glutaminergic systems, which were mostly conducted in animal models [34][35][36][37]. Among these, the effects of glutaminergic and glucocorticoid com pounds have been investigated in human studies.…”

Section: Neuroleptic Malignant Syndromementioning

confidence: 99%

Pharmacogenetics in Electroconvulsive Therapy and Adjunctive Medications

et al. 2015

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Electroconvulsive therapy (ECT) has shown apparent efficacy in treatment of patients with depression and other mental illnesses who do not respond to psychotropic medications or need urgent control of their symptoms. Pharmacogenetics contributes to an individual's sensitivity and response to a variety of drugs. Clinical insights into pharmacogenetics of ECT and adjunctive medications not only improves its safety and efficacy in the indicated patients, but can also lead to the identification of novel treatments in psychiatric disorders through understanding of potential molecular and biological mechanisms involved. In this review, we explore the indications of pharmacogenetics role in safety and efficacy of ECT and present the evidence for its role in patients with psychiatric disorders undergoing ECT.

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Can ECT-induced cognitive effects be altered pharmacologically?

Cited by 14 publications

References 41 publications

Memory and cognitive effects of ECT: informing and assessing patients^†

Memory and cognitive effects of ECT: informing and assessing patients^†

Efficacy and Side Effects of Mixed-Strategy Electroconvulsive Therapy: A Proof-of-Concept Randomized Clinical Trial on Late Life Depression

Pharmacogenetics in Electroconvulsive Therapy and Adjunctive Medications

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Can ECT-induced cognitive effects be altered pharmacologically?

Cited by 14 publications

References 41 publications

Memory and cognitive effects of ECT: informing and assessing patients†

Memory and cognitive effects of ECT: informing and assessing patients†

Efficacy and Side Effects of Mixed-Strategy Electroconvulsive Therapy: A Proof-of-Concept Randomized Clinical Trial on Late Life Depression

Pharmacogenetics in Electroconvulsive Therapy and Adjunctive Medications

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Product

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Memory and cognitive effects of ECT: informing and assessing patients^†

Memory and cognitive effects of ECT: informing and assessing patients^†