Evaluation of Oxidative Status in Patients Treated with Electroconvulsive Therapy

Abstract

ObjectiveElectroconvulsive therapy (ECT) is used in the treatment of many psychiatric diseases and this therapy may be effective on antioxidant defence system. In this study, we aimed to evaluate the effects of ECT on oxidative stress.MethodsFourteen major depression, 11 schizophrenia and 8 bipolar affective disorder patients diagnosed and received ECT treatment, and 37 healthy volunteers enrolled in the study. ECT was applied to all patients. Before ECT, after the first and last ECTs, serum samples were obtained. Serum total antioxidant status (TAS), total oxidant status (TOS), and calculated oxidative stress index (OSI) were measured in patients before and after ECTs.ResultsTOS values before ECT were higher in major depression (p=0.005) and schizophrenia (p=0.001) groups compared to the control group. TAS values were lower in major depression (p=0.0001), schizophrenia (p=0.004), bipolar affective disorder (p=0.004) groups compared to the controls. Also OSI values were higher in major depression (p=0.0001), schizophrenia (p=0.001), bipolar affective disorder (p=0.009) groups compared to healthy group. After the last ECT, TOS values were significantly lower compared to TOS values before ECT in major depression (p=0.004) and schizophrenia patients (p=0.004). TAS values after the first ECT were higher compared to values before ECT in major depression patients (p=0.004). After last ECT, OSI values were significantly lower compared to before ECT in schizophrenia patients (p=0.006).ConclusionAs a result, it can be said that ECT did not increase oxidative stress. However, further studies with more patients are needed.

Electroconvulsive Therapy and Oxidative Stress: Comment on the Article of Şenyurt et al. (Clin Psychophacol Neurosci 2017;15:40-46)

“…Taken together, in concordance with the current study performed by Şenyurt et al ., 1) our previous study has indicated that ECT may have positive or at least no additional influences on oxidative stress. Studies with larger samples and refined groups from effect of confounders are required to confirm these findings.…”

“…titled “Evaluation of Oxidative Status in Patients Treated with Electroconvulsive Therapy” published in February 2017 in this journal. 1) The authors conducted a study suggesting that electroconvulsive therapy (ECT) has no negative effect on oxidative stress in terms of serum total oxidant status (TOS), total antioxidant status (TAS) and their ratio oxidative stress index (OSI). Even though the sub-groups have small sample size which may be inadequate for a statistically significance, they found that OSI levels were decreased significantly in schizophrenia, insignificantly in bipolar and major depressive groups after ECT when compared with pre-ECT levels.…”

“…Even though the sub-groups have small sample size which may be inadequate for a statistically significance, they found that OSI levels were decreased significantly in schizophrenia, insignificantly in bipolar and major depressive groups after ECT when compared with pre-ECT levels. 1) …”

Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future

“…Regarding clinical investigations, one study revealed that ECT produced a significant reduction in the serum total oxidant status values and a significant increase in total antioxidant status in patients with MDD, showing that ECT did not increase oxidative stress in these patients [ 143 ]. Other authors studied ECT effects on serum markers involved in oxidative regulations, such as malondialdehyde (MDA), nitric oxide (NO) levels, and xanthine oxidase and SOD activities, in patients with MDD and bipolar disorders, and showed that SOD activity decreased after ECT, inferring decreased oxidative responses after this treatment [ 144 ].…”

Can Propofol Lead to an Increase in Seizure Threshold Over the Course of Electroconvulsive Therapy?

“…ECT is a preferred treatment modality in patients with major depression, affective disorders, schizophrenia, and other psychotic disorders, where pharmacological treatment is not adequate, and a rapid clinical response is desired. Several theories were hypothesized about mechanisms of action of ECT-including changes in cerebral blood flow and blood brain barrier, epigenetic modifications, changes in the levels of various hormones, neurotransmitters, and neurotrophic factors, alterations in neuroplasticity, and immune mechanisms [2,3]. In order for ECT to be effective, the required seizure time is > 25 seconds [4,5].…”