Recent Updates on Electro-Convulsive Therapy in Patients with Depression

Park, Mi Jin; Kim, Hyewon; Kim, Young Ho; Yook, Vidal; Chung, In Won; Lee, Sang Min; Jeon, Hong Jin

doi:10.30773/pi.2020.0350

Cited by 23 publications

(12 citation statements)

References 91 publications

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“…Although ECT is generally safe, it may cause memory loss, confusion and low verbal frequency [ 136 ]. These symptoms of cognitive impairment might be associated with decreased functional connectivity between the left pulvinar and bilateral precuneus following ECT [ 137 ].…”

Section: Brain Functional Connectome For Evaluating Treatment Efficacymentioning

confidence: 99%

Understanding complex functional wiring patterns in major depressive disorder through brain functional connectome

et al. 2021

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Brain function relies on efficient communications between distinct brain systems. The pathology of major depressive disorder (MDD) damages functional brain networks, resulting in cognitive impairment. Here, we reviewed the associations between brain functional connectome changes and MDD pathogenesis. We also highlighted the utility of brain functional connectome for differentiating MDD from other similar psychiatric disorders, predicting recurrence and suicide attempts in MDD, and evaluating treatment responses. Converging evidence has now linked aberrant brain functional network organization in MDD to the dysregulation of neurotransmitter signaling and neuroplasticity, providing insights into the neurobiological mechanisms of the disease and antidepressant efficacy. Widespread connectome dysfunctions in MDD patients include multiple, large-scale brain networks as well as local disturbances in brain circuits associated with negative and positive valence systems and cognitive functions. Although the clinical utility of the brain functional connectome remains to be realized, recent findings provide further promise that research in this area may lead to improved diagnosis, treatments, and clinical outcomes of MDD.

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Section: Brain Functional Connectome For Evaluating Treatment Efficacymentioning

confidence: 99%

Understanding complex functional wiring patterns in major depressive disorder through brain functional connectome

et al. 2021

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“…Geriatric patients with combination therapy have faster response rates and lower re-hospitalization rates than patients with early onset depression (i.e. depression ≤55 years of life) [5].…”

Section: Indications For Electroconvulsive Therapy and Conduct Of The...mentioning

confidence: 99%

Electroconvulsive therapy: recent advances and anesthetic considerations

Ninke

Groene

2023

Current Opinion in Anaesthesiology

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Purpose of review This review summarizes the current indications and principles of ECT. Contemporary anesthetic considerations are described with a focus on the optimal use of hypnotic agents and providing ECT in pregnant patients. Recent findings ECT is useful in treatment-resistant major depression, bipolar disorders, and treatment-resistant schizophrenia. It is a well tolerated treatment in pregnant patients with treatment-resistant depression. Cognitive side effects may be attenuated by using unilateral placement of scalp electrodes, fewer treatment sessions, and the use of ultrabrief pulse width of the electrical charge. All modern hypnotics can be used for induction of anesthesia for ECT but should be titrated to effect. Etomidate is superior to Propofol in regarding seizure quality. The use of Ketamine shows good seizure quality and may alleviate cognitive impairment. Providing ECT for pregnant patients may prove challenging because of logistic difficulties and the physiologic changes during pregnancy. Although representing an effective treatment option in severely ill patients, ECT is underutilized because of stigmatization and ethnic and financial disparities. Summary ECT is effective in treating treatment-resistant psychiatric illnesses. Symptoms of cognitive impairment are the most common side effects but can be treated by modifying the technique of ECT. All modern hypnotics can be used for the induction of general anesthesia. Etomidate and Ketamine may be of special interest in patients with insufficient seizure duration. Treating pregnant patients with ECT requires a multidisciplinary approach, in order to provide a safe therapy for mother and unborn child. Stigmatization and social disparities are hindering the widespread use of ECT as an effective treatment for severely ill psychiatric patients.

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“…However, cardiovascular changes and psychiatric complications may occur following treatment. Pulmonary aspiration, respiratory failure, and residual neuromuscular blockade must be considered as possible complications of ECT interventions because neuromuscular blocking agents are used [ 102 ]. Although cognitive impairment is common after ECT, it is not permanent.…”

Section: Drugs For Ectmentioning

confidence: 99%

Anesthetic care for electroconvulsive therapy

et al. 2022

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Counselling and medication are often thought of as the only interventions for psychiatric disorders, but electroconvulsive therapy (ECT) has also been applied in clinical practice for over 80 years. ECT refers to the application of an electric stimulus through the patient’s scalp to treat psychiatric disorders such as treatment-resistant depression, catatonia, and schizophrenia. It is a safe, effective, and evidence-based therapy performed under general anesthesia with muscle relaxation. An appropriate level of anesthesia is essential for safe and successful ECT; however, little is known about this because of the limited interest from anesthesiologists. As the incidence of ECT increases, more anesthesiologists will be required to better understand the physiological changes, complications, and pharmacological actions of anesthetics and adjuvant drugs. Therefore, this review focuses on the fundamental physiological changes, management, and pharmacological actions associated with various drugs, such as anesthetics and neuromuscular blocking agents, as well as the comorbidities, indications, contraindications, and complications of using these agents as part of an ECT procedure through a literature review and our own experiences.

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Recent Updates on Electro-Convulsive Therapy in Patients with Depression

Cited by 23 publications

References 91 publications

Understanding complex functional wiring patterns in major depressive disorder through brain functional connectome

Understanding complex functional wiring patterns in major depressive disorder through brain functional connectome

Electroconvulsive therapy: recent advances and anesthetic considerations

Anesthetic care for electroconvulsive therapy

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