Exceptionally High Initial Seizure Threshold in a Catatonic Patient Treated With Electroconvulsive Therapy

Waarde, Jeroen A. van; Muller, Michael E.M.T.; Verwey, Bastiaan; Mast, Rose C. van der

doi:10.1097/yct.0b013e31817c73c3

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…As elderly depressed patients are at higher risk of serious medical comorbidity, including cardiovascular diseases [42], this clinical factor may contribute to the higher chance of increased seizure thresholds in older patients. Furthermore, such comorbidity often leads to pharmacotherapeutic treatments of which several are known to increase the seizure threshold, in particular anticonvulsants, benzodiazepines, beta-blockers, and calcium antagonists [55]. Although in most studies on the relation of seizure threshold and age the use of psychopharmacological drugs was an exclusion criterion, concomitant use of nonpsychotropic drugs was hardly mentioned.…”

Section: Clinical Factors and Increased Seizure Thresholdmentioning

confidence: 99%

Seizure Thresholds in Elderly Patients Treated with Electroconvulsive Therapy for Major Depressive Disorder: A Review

Waarde¹,

Rose²

2010

CPSR

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Objective: Electroconvulsive therapy (ECT) is effective and generally safe in depression. Its effectiveness and side effects are suggested to be related to the electrical stimulus administered relative to the seizure threshold. Since aging seems to raise the seizure threshold in ECT, we reviewed the literature for evidence correlating advanced age and seizure threshold, and for hypotheses explaining why seizure thresholds might raise with age.Methods: Pubmed, PsychINFO, three standard works on ECT, and cross-references were searched for studies investigating seizure thresholds and/or associated factors in elderly depressed patients.Results: A total of 406 possibly relevant articles were found, of which 27 studies could be included. One very recently published study was included afterwards because of its significance. Aging was moderately associated with a raised initial seizure threshold with correlation coefficients ranging from 0.30 to 0.64 (p<0.05). Also, seizure thresholds in elderly patients were more likely to raise during the ECT course. Reported hypotheses for these clinical phenomena include a decrease of neuroexcitability, changes in morphologic and functional characteristics of the brain, somatic comorbidity, and concomitant medication use.Conclusion: To optimize ECT in elderly patients, hypotheses and suggestions for further research are proposed regarding the moderate correlation between advanced age and initial seizure threshold and the rise in seizure threshold during the ECT course.

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Section: Clinical Factors and Increased Seizure Thresholdmentioning

confidence: 99%

Seizure Thresholds in Elderly Patients Treated with Electroconvulsive Therapy for Major Depressive Disorder: A Review

Waarde¹,

Rose²

2010

CPSR

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“…One of the important points that is important in the treatment process with ECT is a generalized seizure that is caused by the device (tonic and colonic) in the patient. In this episode, a seizure has therapeutic properties that at least 20 seconds [15] can be seen as seizures in the electroencephalogram as visible seizures or 35 seconds [16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Contrary to these effects, sodium thiopental may cause tachycardia, hypotension, anaphylaxis, facial edema, myocardial depression, and some other side effects [30]. Some studies have shown that propofol and thiopental can reduce the duration of seizures [5,31], but propofol is more likely to reduce the duration of seizures compared with thiopental [16,[32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Nanaei

Bahrami

Kasani

2019

JPRI

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Background and Aim: Regarding the controversial results on the effects of anesthetics, especially thiopental sodium, on the duration and severity of seizure and the lack of adequate information on the use of doses of anesthetic and paralysing drugs during ECT, this study was designed to determine the effect of repetitive doses of succinylcholine and Thiopental sodium was administered on the duration and severity of seizure during ECT. Materials and Methods: The present study was a one-blind randomized clinical trial on patients admitted to the psychiatric ward of Dezful Ganjavian Hospital. The research samples were selected after informed consent and entry criteria. Then, the samples were randomly assigned to two groups. In one group, succinylcholine dose was repeated (one third of the initial dose), and in the other group, the dose of thiopental sodium was repeated (one third of the initial dose). In all patients, seizure duration based on EEG monitoring and severity of seizure was determined by the psychiatrist based on the symptoms of the patient during seizure. Results: There was a significant difference between the quality of seizure in the two treatment groups after the intervention. There was a strong and good seizure in the thiopental sodium group (p <0.0001). There was a significant difference between the variables of seizure status in comparison with the previous shock in the two treatment groups after the intervention (p <0.0001). The duration of seizure was higher in thiopental sodium treatment group, but no significant difference was observed (p = 0.82). Conclusion: The results of this study showed that the duration and quality of seizure was better in patients requiring repetitive doses of hypnotic drugs (Thiopental Sodium), which was used to repeat the dose of muscle relaxant (succinylcholine).

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EKT: Komedikation und begleitende Therapien

Bois

Conca

2013

Elektrokonvulsionstherapie Kompakt

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Exceptionally High Initial Seizure Threshold in a Catatonic Patient Treated With Electroconvulsive Therapy

Cited by 6 publications

References 19 publications

Seizure Thresholds in Elderly Patients Treated with Electroconvulsive Therapy for Major Depressive Disorder: A Review

Seizure Thresholds in Elderly Patients Treated with Electroconvulsive Therapy for Major Depressive Disorder: A Review

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

EKT: Komedikation und begleitende Therapien

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