ECT in therapy‐resistant mania: does it have a place?

Fink, Max

doi:10.1111/j.1399-5618.2006.00333.x

Cited by 18 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The early literature on the use of ECT in mania included case studies, uncontrolled trials, naturalistic studies, and retrospective reviews and suffered from some of the same methodological concerns that were discussed above in the context of schizophrenia. However, ECT has shown consistent promise in the treatment of acute as well as treatment-refractory mania 5,55-57. In 1994, Mukherjee et al reviewed 50 years of research on the utility of ECT for treatment of patients with mania 54.…”

Section: Overview Of Efficacy Researchmentioning

confidence: 99%

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Payne

Prudic²

2009

Journal of Psychiatric Practice

147

View full text Add to dashboard Cite

The concept of inducing convulsions, mainly through chemical means, to promote mental wellness has existed since the 16th century. In 1938, Italian scientists first applied electrically induced therapeutic seizures. Although electroconvulsive therapy (ECT) is employed in the treatment of several psychiatric disorders, it is most frequently used today to treat severe depressive episodes and remains the most effective treatment available for those disorders. Despite this, ECT continues to be the most stigmatized treatment available in psychiatry, resulting in restrictions on and reduced accessibility to a helpful and potentially life-saving treatment. The psychiatric and psychosocial ramifications of this stigmatization may include the exacerbation of the increasingly serious, global health problem of major depressive disorders as well as serious consequences for individual patients who may not be offered, or may refuse, a potentially beneficial treatment. The goal of this first article in this two-part series is to provide an overview of ECT's historical development and discuss the current state of knowledge about ECT, including technical aspects of delivery, patient selection, its side-effect profile, and factors that may contribute to underuse of ECT.

show abstract

Section: Overview Of Efficacy Researchmentioning

confidence: 99%

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Payne

Prudic²

2009

Journal of Psychiatric Practice

147

View full text Add to dashboard Cite

show abstract

“…Along with drug treatment, psychotherapy can reduce the amount and severity of episodes, and can increase adherence to drug regimes (CBT: Lam et al, 2000;psychoeducation: Peet & Harvey, 1991). Electroconvulsive therapy is an extremely effective short-term treatment of mania (Fink, 2006) and depression (Daly et al, 2001), however it is currently only used as a last-resort treatment (Goodwin & Jamison, 2007).…”

Section: Bipolar Disorder: Nature Causes and Treatmentmentioning

confidence: 99%

Lay Theories of Bipolar Disorder: the Causes, Manifestations and Cures for Perceived Bipolar Disorder

Furnham

Anthony

2009

Int J Soc Psychiatry

View full text Add to dashboard Cite

This study aimed to investigate lay theories of the cause and treatment of bipolar disorder, and the recognition of its symptoms. This questionnaire-based study included vignette descriptions of mental disorders and 70 items relating to bipolar disorder. It was completed by 173 participants. Bipolar disorder was recognized less than depression but at the same rate as schizophrenia. Contrary to previous research, analysis showed that lay beliefs of the causes of bipolar disorder generally concur with scientific academic theories. Drug treatment was favoured as a cure rather than psychotherapy. Theories of cause and treatment were logically correlated. Overall, the results suggest that lay people have reasonably informed beliefs about the causes and treatments of bipolar disorder, however recognition of the symptoms is poor.

show abstract

“…Lithium is a cornerstone treatment option for bipolar disorders (BD) as well as treatment-resistant major depressive disorder (MDD), as supported by many studies and guidelines [1,2]. Electroconvulsive therapy (ECT) is also the most effective treatment modality for BD and treatment-resistant MDD (TRD) [3]. However, in TRD cases of both BD and MDD, a combination of both lithium and ECT is sometimes needed to improve effectiveness [4,5].…”

Section: Introductionmentioning

confidence: 99%

Combination of lithium and electroconvulsive therapy (ECT) is associated with higher odds of delirium and cognitive problems in a large national sample across the United States

2020

View full text Add to dashboard Cite

Background: Lithium is a helpful adjunct to patients undergoing ECT. However, only case reports and limited data suggest increase risk of delirium. Thus, this continues to be a controversial issue. Objective: In this study, we examine 1) The association and odds of delirium and cognitive problems with ECT and lithium (ECT þ Li) combination compared to ECT alone, 2) If positively associated, would this association vary by both type of mood episode and type of disorder? Methods: A national sample of 64,728 adult psychiatric inpatients across the US (identified from a total data of about 70 million total discharges annually) was analyzed using linear-by-linear association and logistic regression to assess the odds ratio (OR) for delirium and cognitive impairment for those treated with lithium (N ¼ 158), ECT (N ¼ 64148), or ECT þ Li (N ¼ 422) after adjusting for demographics and psychiatric diagnoses. Results: The prevalence of delirium was higher in the ECT þ Lithium group (5.7%) vs. ECT only (0.6%) or lithium only groups (0%). Patients managed with ECT þ Lithium have 11.7-fold higher odds (95% CI 7.55 e17.99, P < 0.001) of delirium compared to ECT alone. In the ECT þ Li group, delirium prevalence was 7.8% in unipolar depression, 3.4% in bipolar depressed, 0% in bipolar mania. Conclusion: These results are surprising given the fading concern about delirium association with ECT þ lithium combination. The high odds in the combination group warrant clinical caution, use of lower lithium doses (if combinations cannot be avoided), and vigilance regarding early signs of delirium. These results warrant replication in future studies.

show abstract

ECT in therapy‐resistant mania: does it have a place?

Cited by 18 publications

References 15 publications

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Lay Theories of Bipolar Disorder: the Causes, Manifestations and Cures for Perceived Bipolar Disorder

Combination of lithium and electroconvulsive therapy (ECT) is associated with higher odds of delirium and cognitive problems in a large national sample across the United States

Contact Info

Product

Resources

About