Electroconvulsive Therapy for Depression in a Liver Transplant Patient

Showalter, Peggy E. Chatham; Young, Stephen; Bilello, John F.; Schäfer, Thomas; Shaver, Timothy R.

doi:10.1016/s0033-3182(93)71835-6

Cited by 7 publications

(6 citation statements)

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“…Electroconvulsive therapy was also beneficial to one of our post‐transplant inpatients, in the same way that a previous report by Showalter et al. described 25 …”

Section: Discussionsupporting

confidence: 85%

“…Electroconvulsive therapy was also beneficial to one of our post-transplant inpatients, in the same way that a previous report by Showalter et al described. 25 Although insomnia is a common symptom and is often the best indicator for poor mental health, surgeons were less likely to prescribe hypnotics for Psychiatry and Clinical Neurosciences 2009; 63: 471-477 dyssomnia than psychiatrists because of their concern for possible liver damage in these relatively stable patients. Three of the eight referral inpatients with 'anxiety/dyssomnia disorder' were given Lorazepam for dyssomnia following the C-L psychiatrist's recommendation.…”

Section: Discussionmentioning

confidence: 99%

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Psychiatric consultation for post‐liver‐transplantation patients

Chiu

Chen

Cheng

2009

Psychiatry Clin Neurosci

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Aim: This report describes the clinical characteristics of referral inpatients who received liver transplantation and the surgeon's concordance with the psychiatric consultation.Methods: During a 4-year period, psychiatric consultation was arranged for 30 post-liver-transplantation inpatients at Kaohsiung Chang Gung Memorial Hospital. A psychiatrist assessed these patients and made psychiatric diagnoses according to the Diagnostic and Statistical Manual, 4th edition. The clinical data were routinely collected via modified MICRO-CARES software. At the end of the 4-year study period, all the medical records of these 30 inpatients were reviewed.Results: Psychiatric diagnosis was made in 70% of the patients (n = 21) in three major categories, including delirious state (n = 8), depressive disorder (n = 5), and anxiety/dyssomnia (n = 8). All these conditions were improved by psychiatric management. We found that the consultee's concordance with recommended drug prescriptions was high with antidepressants in depressive patients and low with antipsychotics in patients with delirium. Moreover, anxiolytics were frequently prescribed in posttransplant inpatients before psychiatric consultation. Conclusion:These findings suggest that psychiatric consultation is beneficial to inpatients after liver transplantation, especially those with depression and delirium.

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“…Electroconvulsive therapy was also beneficial to one of our post‐transplant inpatients, in the same way that a previous report by Showalter et al. described 25 …”

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Psychiatric consultation for post‐liver‐transplantation patients

Chiu

Chen

Cheng

2009

Psychiatry Clin Neurosci

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“…To date, only 4 other reports have appeared of successful ECT in patients with liver transplants, all of which occurred between 8 and 30 months posttransplant 5,8–10. All patients responded robustly to ECT, and none had any complications pertinent to the transplant.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 Severe depression can be life-threatening, because of the risk of suicide, as a consequence of malnutrition and immobility, or due to nonadherence to treatment; these may even threaten the viability of the graft. For example, Showalter et al 5 reported the case of a patient who had stopped his immunosuppressive medications because of a delusional belief that their cost had ruined the US economy. Indeed several studies have demonstrated that untreated depression posttransplant is associated with a higher risk of graft rejection and poorer survival rates.…”

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confidence: 99%

Electroconvulsive Therapy in a Patient With a Liver Transplant

Gunther

Chatham

Stewart

2021

Journal of Psychiatric Practice

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Depression is common in patients after liver transplantation and, when severe, can threaten both viability of the graft and the patient’s life. Electroconvulsive therapy (ECT) is a safe and highly effective therapy for severe depression, but there have been very few reports of its use in liver transplant recipients. We describe a patient who had undergone a successful orthotopic liver transplant 26 years previously, who developed severe major depression. The patient tolerated an index course of ECT well and responded robustly. There were no complications pertinent to the graft or otherwise. Liver transplantation is not a contraindication to ECT, and clinicians should not hesitate to proceed when necessary.

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“…Finally, electroconvulsive therapy has been reported to produce beneficial results in transplant patients. 53,54 CONCLUSION Although transplant patients routinely suffer considerable psychosocial stress throughout the course of transplantation, the benefits of transplant lead most patients to accept the risks. The careful selection of candidates-based on a number of evidence-based psychosocial criteria-can improve outcomes.…”

Section: Treatment Of Comorbid Psychiatric Conditions Following Transmentioning

confidence: 99%

Psychiatric Issues in Solid Organ Transplantation

Heinrich

Marcangelo

2009

Harvard Review of Psychiatry

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The identification and treatment of psychiatric comorbidity in patients undergoing solid organ transplantation present a unique opportunity for psychiatric involvement in the care of medically complex patients. The burden of psychiatric illness in patients awaiting transplant and following transplant is significant and associated with potential morbidity and mortality. Possibilities for psychiatric liaison with our colleagues in transplant medicine and surgery start with the comprehensive psychiatric evaluation that is often performed with potential organ recipients and donors. The vital role of the psychiatrist continues following transplantation, as adjustment is often a stressful experience with associated psychiatric comorbidity. The treatment of psychiatric illness in patients following transplantation requires an understanding of the immunosuppressant medications that patients may be taking, coupled with an awareness of the associated risks of adverse effects and drug-drug interactions.

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Electroconvulsive Therapy for Depression in a Liver Transplant Patient

Cited by 7 publications

References 3 publications

Psychiatric consultation for post‐liver‐transplantation patients

Psychiatric consultation for post‐liver‐transplantation patients

Electroconvulsive Therapy in a Patient With a Liver Transplant

Psychiatric Issues in Solid Organ Transplantation

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