Efficacy and safety of electroconvulsive therapy plus medication versus medication alone in acute mania: A meta-analysis of randomized controlled trials

Zhang, Jian; Wang, Guojun; Yang, Xi; Gao, Keming

doi:10.1016/j.psychres.2021.114019

Cited by 13 publications

(7 citation statements)

References 39 publications

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“…Es posible que en la Facultad de Medicina se dé información más fidedigna sobre el procedimiento y las indicaciones del mismo que permitan tener una opinión distinta a la popular mediatizada por películas tanto nacionales (como "Hombre mirando al sudeste") como internacionales (como "Atrapado sin salida"). Sin embargo, en nuestro estudio menos de un cuarto de los alumnos de Medicina (y un porcentaje casi similar de alumnos de Psicología) afirmó que la TEC produce resultados positivos como lo sostiene la bibliografía (Bahji et al, 2019;Wang et al, 2018;Zhang et al, 2021). Sin embargo, este claro beneficio observado en los anteriores trabajos contrasta con un artículo reciente de Cochrane que, a pesar de confirmar la eficacia en la esquizofrenia refractaria, indica que los estudios en otras patologías son de moderada calidad y se necesitan más estudios para tener conclusiones (Sinclair et al, 2019).…”

Section: Discussionunclassified

Diferencias de opiniones y posturas sobre temas de práctica psiquiátrica entre alumnos superiores de Medicina y de Psicología

Leiderman

Agnessi

Balbiani

et al. 2022

Vertex Rev Arg Psiquiatr

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Introducción: Dada la prevalencia del modelo de atención interdisciplinaria en salud mental es necesario establecer miradas comunes en relación a prácticas terapéuticas de las distintas disciplinas que intervienen en la atención mental. Nuestro objetivo fue determinar si hay diferencias de opiniones y posturas en cuanto a temas de práctica psiquiátrica entre alumnos de Medicina y Psicología de años superiores. Métodos: Se realizó una encuesta ad hoc con distintas afirmaciones sobre la internación psiquiátrica, la terapia electroconvulsiva y los psicofármacos. Ciento dieciocho estudiantes de Medicina y 122 estudiantes de Psicología contestaron esta encuesta en forma online en febrero del año 2022. Resultados: Un tercio de las opiniones fueron significativamente distintas entre los alumnos. Los alumnos de Medicina tuvieron posturas un poco más positivas en relación a la terapia electroconvulsiva y a la internación psiquiátrica que los alumnos de Psicología. El prejuicio en relación a prácticas psiquiátricas es importante en ambos grupos. Discusión y Conclusiones: No existen diferencias importantes entre las opiniones de los alumnos de Medicina y Psicología. El estigma y prejuicio sobre la salud mental debe ser abordado desde los primeros años de ambas carreras.

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Section: Discussionunclassified

Diferencias de opiniones y posturas sobre temas de práctica psiquiátrica entre alumnos superiores de Medicina y de Psicología

Leiderman

Agnessi

Balbiani

et al. 2022

Vertex Rev Arg Psiquiatr

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“…These remarkable efficacy data of ECT were mainly found in the predominant indication of therapy-resistant depression and have stimulated ECT to be used successfully in a variety of mental and neurological disorders such as first-episode schizophrenia ( Grover et al, 2019 ), acute mania ( Zhang et al, 2021 ), during the early stages of antidepressive treatment ( Haq et al, 2015 ; van Diermen et al, 2018 ), for motor and behavioral symptoms of Parkinson’s disease ( Takamiya et al, 2021 ), and for sustaining mood improvement in geriatric depression ( Kellner et al, 2016 ). Furthermore, ECT is particularly effective in patients with depression, including psychotic features and elderly people with depression ( van Diermen et al, 2018 ), to be beneficial as an augmenting strategy in treatment-resistant schizophrenia ( Grover et al, 2019 ; Sinclair et al, 2019 ; Chiu et al, 2020 ) with maintenance ECT providing an effective form of relapse prevention ( Ward et al, 2018 ), in mania ( Elias et al, 2021 ), catatonia ( Kellner et al, 2020 ), severe agitation ( Grover et al, 2019 ), specific mental disorders in multiple sclerosis ( Yahya and Khawaja, 2021 ), and prepartum and postpartum psychotic states ( Gazdag et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Hajak

Hajak²,

Ziegelmayer³

et al. 2021

Front. Psychol.

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Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression. Its clinical use is mainly limited by historical objections and the concern about unwanted adverse effects (AEs), including serious and potentially life-threatening adverse events (pLTAEs), induced either by ECT or by anesthesia. Objective risk estimation is, therefore, a decisive factor in determining an indication for ECT.Methods: This paper presents a retrospective analysis of 3-year safety protocols and patient files of 157 patients who received a total of 3,106 ECT applications in a psychiatric inpatient setting at a psychiatric community hospital. This patient group comprises 5.3% of inpatients admitted with comparable diagnoses. Adverse events were analyzed from standardized safety protocols and patient files with a focus on pLTAEs.Results: Adverse events were reported for 30 (19.1%) of the 157 participants during 39 (6.1%) of 641 hospital stays. Serious pLTAEs occurred during three electroconvulsive stimulations in three patients, who needed action through the administration of medication or mechanical respiration. No patient suffered permanent damage to health, and no patient died. The incidence of these and other AEs was independent of sex, age, and diagnosis of patients, and anesthesia medication. Minor AEs occurred more often with higher stimulus doses and an increasing number of treatments.Conclusion: The low incidence rate of 0.097% of serious pLTAEs that require medical action may allow the conclusion that ECT is a rather safe treatment when performed in a controlled setting. The beneficial risk profile of ECT performed in the standard care of psychiatric hospitals suggests a more generous indication of this treatment method. We recommend that ECT facilities collect individual safety data to allow a reliable judgment of their institutional ECT risk profile.

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“…Day 5 4. If treatment with the above-mentioned points 1-3 has not reduced the severity of the manic episode after five days, the decision is made for either valproate as augmenting therapy (note contraindicated for fertile women, and normal liver tests are required) or ECT [18].…”

Section: If the Patient Does Not Tolerate Olanzapinementioning

confidence: 99%

An algorithm for pharmacological treatment of mania during hospitalisation

Kessing,

Christensen,

Larsen

et al. 2024

Dan Med J

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Current evidence for pharmacological treatment of mania during hospitalisation is insufficient as there are no larger well-designed randomised trials of comparative medical treatments of mania during inpatient stays. Moreover, there is considerable variation in pharmacological medication in clinical practice during hospitalisation for mania. Based on a hospital data overview, a systematic search of the literature and a three-day consensus meeting, this narrative review proposed an algorithm for optimised pharmacological treatment of mania during hospitalisation and its subsequent scientific evaluation.

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Efficacy and safety of electroconvulsive therapy plus medication versus medication alone in acute mania: A meta-analysis of randomized controlled trials

Cited by 13 publications

References 39 publications

Diferencias de opiniones y posturas sobre temas de práctica psiquiátrica entre alumnos superiores de Medicina y de Psicología

Diferencias de opiniones y posturas sobre temas de práctica psiquiátrica entre alumnos superiores de Medicina y de Psicología

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

An algorithm for pharmacological treatment of mania during hospitalisation

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