Electroconvulsive Therapy in Treatment-Resistant Bipolar Youth

Kutcher, Stan; Robertson, Heather A.

doi:10.1089/cap.1995.5.167

Cited by 69 publications

(43 citation statements)

References 3 publications

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“…Schneekloth et al (1993), in a retrospective chart review, reported IQ changes following ECT in 3 of 20 adolescents (aged 13-18 years); 1 patient gained 26 points on his full scale IQ score after ECT, 1 had suffered a decline of 4 points at 3-month followup, and 1 subject tested 18 points lower at 7-year follow-up. Bertagnoli and Borchardt (1990), Cizadlo and Wheaton (1995), and Kutcher and Robertson (1995) did not report post-ECT cognitive status of their cases. Only repeated cognitive testing, over the course of several months, can clarify questions regarding longterm cognitive outcome, and none of the available reports in youth provide such data.…”

Section: Discussionmentioning

confidence: 90%

“…They reported a lack of correlation between electrode placement and response, lack of evidence for prolonged seizures especially in subjects below age 15 years, and significant improvement in 13 of 20 patients (65%). More recently, Cizadlo and Wheaton (1995) reported improvement in an 8-year-old girl with severe depression with catatonic features, and Kutcher and Robertson (1995) reported benefit in a series of 16 bipolar youth who had failed to respond to a combined trial of a mood stabilizer and a neuroleptic. Moise and Petrides (1996), in a retrospective chart review of cases treated between 1983-1993, reported improvement in 10 of 13 adolescents with various psychiatric conditions (major depression, bipolar disorder, catatonia, psychosis NOS).…”

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confidence: 99%

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Electroconvulsive Treatment in Adolescents with Pharmacotherapy–Refractory Depression

Ghaziuddin¹,

King²,

Naylor³

et al. 1996

Journal of Child and Adolescent Psychopharmacology

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The effectiveness and safety of ECT in pharmacotherapy-refractory depression was examined in 11 hospitalized adolescents (ages 16.3 +/- 1.7 years, 10 females) with a primary DSM-III-R diagnosis of mood disorder, which had failed to respond to three or more adequate trials of antidepressant pharmacotherapy. After a thorough diagnostic evaluation, patients received a course of ECT involving 11.2 +/- 2.0 (range 8-15) administrations. ECT was commenced with bilateral treatment in 2 adolescents and nondominant right electrode placement in 9 patients; 5 of the 9 patients were subsequently changed to bilateral treatment. All 11 patients improved to a clinically significant degree. Significant improvements were noted in scores on the Children Depression Rating Scale-Revised (CDSR-R) and the Global Assessment of Functioning Scale (GAF) (p < 0.05). Euthymia, defined as CDRS-R score < or = 40, was achieved by 64% (7/11) of patients. The Mini-Mental State Examination showed no significant decline in cognitive functioning. Neuropsychological testing completed in 5 subjects both before ECT and 1-5 days after the last treatment, indicated a significant decline in attention, concentration, and long-term memory search. Minor side effects, experienced within the first 12 hours of treatment, were headache (80% of patients) and nausea/vomiting (64%). The potentially serious complication of tardive seizure (after full recovery of consciousness) occurred in 1 adolescent. Prolonged seizures (> 2.5 minutes) were noted in 7 of the 11 patients (9.6% of the 135 ECT administrations). Pending further research on ECT in youth, it is recommended that ECT should only be administered to youth in hospital settings, that all regularly administered psychotropic medications (including antidepressants) be discontinued before ECT and restarted after the final administration of ECT, and that physicians be aware that 12 treatments are usually sufficient, but that 15 treatments may occasionally be necessary for treating depressed adolescents. With the understanding that scientific evaluation of ECT in youth is lacking, it appears that ECT can be an effective and relatively safe treatment for depressed adolescents who have failed to respond to antidepressant pharmacotherapy.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Electroconvulsive Treatment in Adolescents with Pharmacotherapy–Refractory Depression

Ghaziuddin¹,

King²,

Naylor³

et al. 1996

Journal of Child and Adolescent Psychopharmacology

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“…Kutcher and Robertson (1995) studied a sample of 22 young patients, aged between 13 and 19, in whom a bipolar disorder was diagnosed and divided them into two groups: 16 who accepted ECT and 6 who refused it and continued with pharmacological treatment. A significant improvement of clinical symptoms was observed in the ECT group.…”

Section: Discussionmentioning

confidence: 99%

Two-Year Follow-Up of Cognitive Functions in Schizophrenia Spectrum Disorders of Adolescent Patients Treated with Electroconvulsive Therapy

Serna

Flamarique

Castro‐Fornieles

et al. 2011

Journal of Child and Adolescent Psychopharmacology

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Objective: The aim of the current study was to investigate the long-term cognitive effects of electroconvulsive therapy (ECT) in a sample of adolescent patients in whom schizophrenia spectrum disorders were diagnosed. Methods: The sample was composed of nine adolescent subjects in whom schizophrenia or schizoaffective disorder was diagnosed according to DSM-IV-TR criteria on whom ECT was conducted (ECT group) and nine adolescent subjects matched by age, socioeconomic status, and diagnostic and Positive and Negative Syndrome Scale (PANSS) total score at baseline on whom ECT was not conducted (NECT group). Clinical and neuropsychological assessments were carried out at baseline before ECT treatment and at 2-year follow-up. Results: Significant differences were found between groups in the number of unsuccessful medication trials. No statistically significant differences were found between the ECT group and the NECT group in either severity as assessed by the PANSS, or in any cognitive variables at baseline. At follow-up, both groups showed significant improvement in clinical variables (subscales of positive, general, and total scores of PANSS and Clinical Global Impressions-Improvement). In the cognitive assessment at follow-up, significant improvement was found in both groups in the semantic category of verbal fluency task and digits forward. However, no significant differences were found between groups in any clinical or cognitive variable at follow-up. Repeated measures analysis found no significant interaction of time · group in any clinical or neuropsychological measures. Conclusions: The current study showed no significant differences in change over time in clinical or neuropsychological variables between the ECT group and the NECT group at 2-year follow-up. Thus, ECT did not show any negative influence on long-term neuropsychological variables in our sample.

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“…Short-term outcome was poorly described in 35% (N=21), while information on longer-term outcome (6 or more months after ECT) was provided in less than one-half (42%, N=25) of the studies. Only two reports (45,56) used quantitative measures of outcome.…”

Section: Quality Of the Evidencementioning

confidence: 99%

“…The parents and the child should be involved whenever possible and should be given adequate information. The opportunity to discuss ECT with other young people who have received it may be helpful (56). CONCLUSIONS "On February 10, 1977, electroconvulsive treatment was administered for the first time to a 16-year-old female who had not eaten, spoken or walked unaided for the past four months .…”

Section: Implications For Education and Clinical Practicementioning

confidence: 99%

Half a century of ECT use in young people

1997

AJP

188

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Electroconvulsive Therapy in Treatment-Resistant Bipolar Youth

Cited by 69 publications

References 3 publications

Electroconvulsive Treatment in Adolescents with Pharmacotherapy–Refractory Depression

Electroconvulsive Treatment in Adolescents with Pharmacotherapy–Refractory Depression

Two-Year Follow-Up of Cognitive Functions in Schizophrenia Spectrum Disorders of Adolescent Patients Treated with Electroconvulsive Therapy

Half a century of ECT use in young people

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