Características clínicas de pacientes tratados con terapia electroconvulsiva en un hospital público de Perú

Cortez-Vergara, Carla; Cruzado, Lizardo; Rojas-Rojas, Ira Galia; Sánchez-Fernández, Miguel; Ladd-Huarachi, Guillermo

doi:10.17843/rpmesp.2016.331.1940

Cited by 5 publications

(10 citation statements)

References 17 publications

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“…2019; 82(2):156-161 efectivos -de hecho, no se recomienda el uso más prolongado de benzodiacepinas, pues no se halla libre de complicaciones-debiera plantearse el uso de TEC (22). Es posible que en nuestro medio, tal recomendación no se esté cumpliendo cabalmente, por una actitud excesivamente conservadora que lleva a la inhibición terapéutica del profesional prescriptor (1,3). De hecho, se propugna que la intervención temprana debiera ser considerada antes del deterioro clínico del paciente (6,7).…”

Section: Discussionunclassified

“…En nuestro medio, el uso de la terapia electroconvulsiva (TEC) está experimentando un declive (1). Usualmente se concibe a esta terapia como un recurso destinado solamente a casos refractarios y crónicos (2), y se ha descrito un proceso de "inhibición terapéutica" por el que los psiquiatras, pese a conocer de la eficacia de la TEC, son poco proclives a indicarla (3).…”

Section: Introductionunclassified

“…El objetivo del presente reporte es dar relieve a la indicación de la TEC en casos de psicosis que no son crónicos ni refractarios, indicación que es usualmente soslayada en nuestro medio (1), en base al caso de un ciudadano migrante quien desarrolló un trastorno psicótico agudo polimorfo con síntomas catatónicos y resolvió su enfermedad prácticamente con una sola aplicación de TEC, lo cual también es inédito en la literatura. Además revisamos brevemente la bibliografía actual.…”

Section: Introductionunclassified

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Respuesta ultrarrápida a la terapia electroconvulsiva en un caso de trastorno psicótico agudo polimorfo.

et al. 2019

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Existe la errónea percepción de que la Terapia Electroconvulsiva (TEC) debe usarse como último recurso de manejo psiquiátrico y únicamente en casos crónicos y/o refractarios. Esto, entre otras causas, ha llevado a la lamentable disminución de su empleo a lo largo de los últimos tiempos en nuestro medio y en otras latitudes. Sin embargo, las psicosis agudas con síntomas motores de tipo catatoniforme presentan tasas de respuesta de hasta 100% y la TEC debiera, por ende, hallarse en la primera línea de los recursos de tratamiento para estos cuadros, evitando o previniendo, de ese modo, connsecuencias ominosas de la catatonía. A propósito de un cuadro de trastorno psicótico agudo polimorfo sin síntomas de esquizofrenia (F23.0, CIE-10) que presentó remisión completa de síntomas catatónicos y psicóticos luego de una sola sesión de TEC (lo que es, de hecho, un resultado infrecuente), se realiza una revisión de la literatura pertinente. Se concluye que la TEC debiera retomar su relevancia en casos psicóticos agudos de buen pronóstico, en los que su postergación acarreará consecuencias innecesariamente negativas.

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Section: Discussionunclassified

Section: Introductionunclassified

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Respuesta ultrarrápida a la terapia electroconvulsiva en un caso de trastorno psicótico agudo polimorfo.

et al. 2019

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“…The principles of this technique are the induction of a series of tonic-clonic seizures through an electric discharge in patients who have been previously examined and sedated with anesthetics and muscle relaxants. The relative contraindications and the number of sessions are determined by the specific pathology and the individual needs of each patient [4,5]. Likewise, there are different variants of this therapy, including modifications of the position of the electrodes and the amplitude of the electric pulse.…”

Section: Introductionmentioning

confidence: 99%

Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications

Rojas

Ariza

Ortega

et al. 2022

IJMS

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Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms “electroconvulsive therapy”, “neurobiological effects of electroconvulsive therapy”, “molecular mechanisms in electroconvulsive therapy”, and “psychiatric disorders” were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus–hypophysis–adrenal and hypothalamus–hypophysis–thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson’s disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive–compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.

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“…3,4 Despite the recognized importance of practice decisions and the global prevalence of ECT, there has never been a published survey of worldwide ECT practice. Country-specific surveys on ECT practice have been published including from Australia, 5,6 Belgium, 7,8 Bulgaria, 9 Canada, [10][11][12] China, 13,14 Croatia, 15 Czech Republic, 16 Denmark, 17 Germany, 18 Greece, 19 Hungary, 20,21 India, 22,23 Iraq, 24 Italy, 25 Netherlands, 26 New Zealand, 27 Peru, 28 Poland, 29,30 Russia, 31 Serbia, 32 South Africa, 33 Slovakia, 34 Spain, 35,36 Thailand, 37 Ukraine, 38 the United Kingdom (UK), 39,40 and the United States (US). 41,42 Regional surveys encompassing multiple countries have been published for Asia, 43 Baltic States, 44 and Central-Eastern European countries.…”

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Electroconvulsive Therapy Across Nations

Rohde,

Noorani,

Feuer

et al. 2023

J ECT

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Objectives We aimed to characterize worldwide electroconvulsive therapy (ECT) practice and compare practice across nations and global regions. Method Our anonymous survey was open on SurveyMonkey.com from January to June 2022. We sent invitations to providers identified using a Medicare provider database, an advanced PubMed search function, and professional group listservs. Participants were instructed to submit one survey per ECT site. Response frequencies were pooled by global region and compared using nonparametric methods. Results Responses came from 126 sites, mostly in the United States (59%, n = 74), Europe (18%, n = 23), Canada (10%, n = 12), and South/East Asia (6%, n = 8). With some exceptions, sites were broadly consistent in practice as indicated by: a likely shift internationally from bitemporal to right unilateral electrode placement; predominant use of pulse widths <1 ms; preference for seizure threshold titration over age-based dosing methods; widespread availability of continuation/maintenance ECT (97%); and frequent use of quantitative outcome measures for depressive symptoms (88%) and cognitive adverse effects (80%). Conclusions This is the first, published survey that aimed to characterize worldwide ECT practice. With some exceptions, responses suggest a concordance in practice. However, responses were primarily from the Global North. To obtain a truly worldwide characterization of practice, future surveys should include more responses from the Global South.

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Características clínicas de pacientes tratados con terapia electroconvulsiva en un hospital público de Perú

Cited by 5 publications

References 17 publications

Respuesta ultrarrápida a la terapia electroconvulsiva en un caso de trastorno psicótico agudo polimorfo.

Respuesta ultrarrápida a la terapia electroconvulsiva en un caso de trastorno psicótico agudo polimorfo.

Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications

Electroconvulsive Therapy Across Nations

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