Predictors of Electroconvulsive Therapy Postictal Delirium

Reti, Irving M.; Krishnan, Arunkumar; Podlisky, Adam; Sharp, April; Melinda, Walker; Neufeld, Karin J.; Hayat, Matthew J.

doi:10.1016/j.psym.2013.03.004

Cited by 42 publications

(36 citation statements)

References 36 publications

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“…6 According to the analysis of Reti et al, a patient with a RASS score ≥ 2 was considered hazardous because a RASS score of 2 was the threshold for dangerous levels of agitation. 4 Before ECT, routine monitoring of electrocardiogram (ECG), pulse oxygen saturation (SpO 2 ) and blood pressure (BP) were performed for each patient. Anesthesia was induced by 1.5 mg/kg of propofol, and then 0.7 mg/kg succinylcholine was intravenously injected to act as a muscle relaxant.…”

Section: Methodsmentioning

confidence: 99%

“…One such adverse effect is postictal delirium (PID), which has been identi ed as a relatively common adverse effect that usually occurs immediately after the ECT procedure, with a reported incidence for at least one third of the treatments. 4,5 The clinical manifestations of the PID state mainly include lack of awareness, perceptual disturbance, agitation, and sometimes erratic and/or violent behavior. A series of adverse outcomes, such as falls, fractures, need for extra nursing care, and physical restraint related to psychomotor agitation might come as a result of PID.…”

Section: Introductionmentioning

confidence: 99%

“…A series of adverse outcomes, such as falls, fractures, need for extra nursing care, and physical restraint related to psychomotor agitation might come as a result of PID. [3][4][5] Thus, a more thorough and detailed recognition of the risk factors related to PID could be helpful in preventing and treating this unwanted outcome that is commonly associated with ECT.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

Cheng

Deng

et al. 2020

Asian Journal of Psychiatry

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Aim: This study aimed to elucidate the incidence and risk factors for postictal delirium (PID) among Chinese patients undergoing electroconvulsive therapy (ECT). Methods: In this retrospective study, 203 patients who underwent ECT in the Third A liated Hospital of Sun Yat-Sen University from July 2016 to July 2017 had their PID severity measured by a previously developed scale. For data analysis, two groups were created: PID patients and non-PID patients. The groups were analyzed based on three types of independent variables: patient-related, electroconvulsive treatment, and hemodynamic variables. Data analysis was performed through descriptive statistics, Chisquared tests, Fisher exact tests, and/or independent sampled t-tests. Logistic regression analysis was used to identify independent risk factors for postictal delirium (P < 0.05). Results: Results showed that 81 patients (39.9%) developed moderate to severe PID in their rst ECT session. Patients receiving ECT for the rst time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identi ed as risk factors for PID, and they were signi cantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the rst time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID. The medical staff related to this type of treatment may bene t from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

Cheng

Deng

et al. 2020

Asian Journal of Psychiatry

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Section: Introductionmentioning

confidence: 99%

Cognitive functioning in patients treated with electroconvulsive therapy

Kališová

Kubinova

Michalec

et al. 2018

NDT

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BackgroundElectroconvulsive therapy (ECT) is an effective treatment method for severe mental illnesses. ECT has gone through significant modernization. Side effects of ECT have largely decreased. Temporary disturbance of cognitive performance can be still present as a side effect of electroconvulsive treatment.MethodsCognitive functioning in the sample of patients with severe and acute mental illness treated with electroconvulsive therapy (ECT) was assessed. Basic assessment of cognitive functions was applied in the beginning, in the middle, and at the end of ECT course treatment with the Montreal Cognitive Assessment (MoCA). Complex and detailed testing of cognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) was done at two points in time – within the first week of and then 6 weeks after the end of ECT.ResultsParticipants had cognitive deficits at baseline, which were most likely influenced markedly by the psychopathology of the illness itself. The improvement in cognition came together with the reduction in psychopathology; psychopathology scores were significantly reduced during ECT treatment. Compared to the baseline, all scores for cognitive testing were significantly improved but remained low in comparison with the controls. After 6 weeks, there was further significant improvement.ConclusionOur results confirm the safety and efficacy of ECT in the treatment of severe mental disorders.

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“…The most frequently occurring cognitive side effects mainly include postictal disorientation, 10,11 temporary disturbance of anterograde memory, and less proven damage of retrograde memory, which can be longer lasting. [12][13][14][15][16][17][18][19][20] The occurrence of cognitive side effects was proven to be influenced by different possible factors: 1) the technical parameters of ECT (right-unilateral [RUL] superior to bilateral, shorter pulse width, non-sine shape of wave, lower dose of electric current, and lower frequency of application of ECT), [21][22][23] 2) psychiatric illness and psychopathology, 24,25 3) psychiatric medication, 4) type of anesthetic, 26,27 and 5) age, overall state of brain (level of cognitive functioning), and cognitive reserve.…”

Section: Introductionmentioning

confidence: 99%

Cognitive functioning in patients treated with electroconvulsive therapy

Kališová¹

2018

Preprint

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Background: Electroconvulsive therapy (ECT) is an effective treatment method for severe mental illnesses. ECT has gone through significant modernization. Side effects of ECT have largely decreased. Temporary disturbance of cognitive performance can be still present as a side effect of electroconvulsive treatment. Methods: Cognitive functioning in the sample of patients with severe and acute mental illness treated with electroconvulsive therapy (ECT) was assessed. Basic assessment of cognitive functions was applied in the beginning, in the middle, and at the end of ECT course treatment with the Montreal Cognitive Assessment (MoCA). Complex and detailed testing of cognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) was done at two points in time-within the first week of and then 6 weeks after the end of ECT. Results: Participants had cognitive deficits at baseline, which were most likely influenced markedly by the psychopathology of the illness itself. The improvement in cognition came together with the reduction in psychopathology; psychopathology scores were significantly reduced during ECT treatment. Compared to the baseline, all scores for cognitive testing were significantly improved but remained low in comparison with the controls. After 6 weeks, there was further significant improvement. Conclusion: Our results confirm the safety and efficacy of ECT in the treatment of severe mental disorders.

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Predictors of Electroconvulsive Therapy Postictal Delirium

Cited by 42 publications

References 36 publications

Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

Cognitive functioning in patients treated with electroconvulsive therapy

Cognitive functioning in patients treated with electroconvulsive therapy

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