Serum lipid profile changes after successful treatment with electroconvulsive therapy in major depression: A prospective pilot trial

Aksay, Suna Su; Bumb, Jan Malte; Janke, Christoph; Biemann, Ronald; Borucki, Katrin; Lederbogen, Florian; Deuschle, Michael; Sartorius, Alexander; Kranaster, Laura

doi:10.1016/j.jad.2015.09.037

Cited by 25 publications

(19 citation statements)

References 27 publications

(22 reference statements)

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“…[ 19 ] The most anesthesia drugs with short effect that using in ECT decreasing the seizure time or other complication of psychiatric disorders based on dosage in depressive patients. [ 4 13 14 18 21 22 23 ] Therefore, narcotics such as alfentanil used for increasing of seizure time beside anesthesia drugs synthetic or separately. [ 10 24 25 ] Moreover, the effect of dexmedetomidine on seizure is evaluated in different studies.…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric illnesses are one of the important health problems due to its dysfunction and burden of diseases in developing countries[ 1 ] and related to many functional disorders and economical cost in health. [ 1 2 3 4 ] Electroconvulsive therapy (ECT) is an effective and well-established treatment for a variety of psychiatric illnesses[ 4 ] such as patients with persistent and severe depression who have not responded to pharmacotherapy. [ 5 6 ] Nevertheless, all the ECT procedures were conducted under the full anesthesia and after muscular sleazy.…”

Section: Introductionmentioning

confidence: 99%

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Premedication effect of dexmedetomidine and alfentanil on seizure time, recovery duration, and hemodynamic responses in electroconvulsive therapy

Moshiri¹,

Modir²,

Bagheri³

et al. 2016

Ann Card Anaesth

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Introduction:Electroconvulsive therapy (ECT) is an effective treatment for many mental disorders, especially severe and persistent depression, bipolar disorder, and schizophrenia. The aim of this study is to compare the effect of dexmedetomidine and alfentanil on agitation, satisfaction, seizure duration, and patients hemodynamic after ECT.Materials and Methods:In a three phase crossover randomized clinical trial, 75 patients aged between 18 and 50 years and candidate for ECT were enrolled and assigned into three groups (25 patients in each group). All patients, respectively, took premedication of dexmedetomidine, alfentanil, or saline in three consecutive phases. Patients received 0.5 μg/kg dexmedetomidine, 10 μg/kg alfentanil or normal saline intravenously, 10 min before induction. Finally, seizure and recovery duration, satisfaction and agitation score, and hemodynamic parameters were evaluated.Results:There was no significant difference about seizure duration, agitation score, and hemodynamic parameters between groups but recovery duration was significantly lower in the control group than dexmedetomidine (P = 0.016) and alfentanil group (P = 0.0001). Patients’ satisfaction was significantly higher in intervention groups (alfentanil and dexmedetomidine groups) (P = 0.0001).Conclusion:Given the equal effects of alfentanil and dexmedetomidine, it seems that choosing one of these two drugs for premedication of patients undergoing ECT is appropriate. Drug choice is influenced by numerous factors such as accessibility of each drug and the dominance of anesthesiologist and psychiatrist.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Premedication effect of dexmedetomidine and alfentanil on seizure time, recovery duration, and hemodynamic responses in electroconvulsive therapy

Moshiri¹,

Modir²,

Bagheri³

et al. 2016

Ann Card Anaesth

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“…For example, low total cholesterol (TC) and LDL cholesterol (LDLC) have been reported by several prospective studies and metaanalyses investigating lipid profiles in patients afforded a diagnosis of MDD [10][11][12][13][14]. Interestingly, TC and LDL levels may be normalised in responders to electroconvulsive therapy (ECT) [10,14], reviewed in [15]. Low highdensity lipoprotein (HDL) is another common finding in these individuals, which is somewhat more in line with a lipid profile expected in patients at increased risk of developing CVD [13,14,16,17].…”

Section: Introductionmentioning

confidence: 99%

Endothelial dysfunction in neuroprogressive disorders—causes and suggested treatments

Morris

Puri²,

Olive

et al. 2020

BMC Med

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Background Potential routes whereby systemic inflammation, oxidative stress and mitochondrial dysfunction may drive the development of endothelial dysfunction and atherosclerosis, even in an environment of low cholesterol, are examined. Main text Key molecular players involved in the regulation of endothelial cell function are described, including PECAM-1, VE-cadherin, VEGFRs, SFK, Rho GEF TRIO, RAC-1, ITAM, SHP-2, MAPK/ERK, STAT-3, NF-κB, PI3K/AKT, eNOS, nitric oxide, miRNAs, KLF-4 and KLF-2. The key roles of platelet activation, xanthene oxidase and myeloperoxidase in the genesis of endothelial cell dysfunction and activation are detailed. The following roles of circulating reactive oxygen species (ROS), reactive nitrogen species and pro-inflammatory cytokines in the development of endothelial cell dysfunction are then described: paracrine signalling by circulating hydrogen peroxide, inhibition of eNOS and increased levels of mitochondrial ROS, including compromised mitochondrial dynamics, loss of calcium ion homeostasis and inactivation of SIRT-1-mediated signalling pathways. Next, loss of cellular redox homeostasis is considered, including further aspects of the roles of hydrogen peroxide signalling, the pathological consequences of elevated NF-κB, compromised S-nitrosylation and the development of hypernitrosylation and increased transcription of atherogenic miRNAs. These molecular aspects are then applied to neuroprogressive disorders by considering the following potential generators of endothelial dysfunction and activation in major depressive disorder, bipolar disorder and schizophrenia: NF-κB; platelet activation; atherogenic miRs; myeloperoxidase; xanthene oxidase and uric acid; and inflammation, oxidative stress, nitrosative stress and mitochondrial dysfunction. Conclusions Finally, on the basis of the above molecular mechanisms, details are given of potential treatment options for mitigating endothelial cell dysfunction and activation in neuroprogressive disorders.

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“…ECT is one of the most effective treatments for many diseases [3], which has been found to be a safe and effective choice for the treatment of mood disorders [4].…”

Section: Introductionmentioning

confidence: 99%

“…One of the complications of electric shock is sudden parasympathetic release at the moment of electric shock, which anticholinergic drugs are often used to reduce this complication before an electric shock. Immediately after the parasympathetic release, the sympathetic system activates, increasing the patient's heart rate (HR) and blood pressure (BP), and even causes cardiac arrhythmias, such as fluttering sensation (palpitations) and atrial fibrillation [3]. Although ECT is a very safe treatment and has no absolute contraindication, both the physician and the patient must be aware of a number of side effects, such as cognitive impairment, which is rapidly resolved in most cases.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Adjunctive use of Dexmedetomidine and Metoral with Thiopental on Hemodynamic Status, Agitation, and Patient Satisfaction in Patients with Mood Disorders after Electroconvulsive Therapy

Mohammadi¹,

Jamilian²,

Alaghemand³

et al. 2020

Open Access Maced J Med Sci

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AIM: The aim of our study was to determine the effect of adjunctive use of dexmedetomidine and metoral with thiopental on hemodynamic status, agitation, patient satisfaction, and duration of seizure in patients with mood disorders in electroconvulsive therapy (ECT). METHODS: This study is a randomized, double-blind, clinical trial. Sixty patients (18–60 years) according to DSM5 criteria had mood disorder and were candidates for ECT. Patients were randomly divided into two groups of 30 each. One group received 5.0 μg/kg dexmedetomidine 10 min before induction of thiopental, and the other group received 5.2 mg intravenous metoprolol immediately before ECT. Patients’ satisfaction, duration of seizure, and arterial oxygen saturation were evaluated. RESULTS: The mean age of both groups was approximately 37 years with the majority of men. No significant difference was found between the two groups in terms of age and sex, blood pressure (BP), heart rate (HR), duration of seizure, and arterial oxygen saturation before ECT. The mean BP and HR in the recovery were lower in the dexmedetomidine group than in the metoral group. Arterial oxygen saturation percentage was not significantly different between the two groups. The recovery time in the dexmedetomidine group was longer than the metoral group (p = 0.001). Post-ECT satisfaction was found to be higher in the dexmedetomidine group than in the metoral group and the mean agitation score was found to be higher in the metoral group. CONCLUSION: Both metoral and dexmedetomidine as adjuvants decrease the hyperdynamic responses of patients after ECT, whereas the effect of dexmedetomidine is more than metoral; on the other hand, neither dexmedetomidine nor metoral has any negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time as compared to metoral.

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Serum lipid profile changes after successful treatment with electroconvulsive therapy in major depression: A prospective pilot trial

Cited by 25 publications

References 27 publications

Premedication effect of dexmedetomidine and alfentanil on seizure time, recovery duration, and hemodynamic responses in electroconvulsive therapy

Premedication effect of dexmedetomidine and alfentanil on seizure time, recovery duration, and hemodynamic responses in electroconvulsive therapy

Endothelial dysfunction in neuroprogressive disorders—causes and suggested treatments

The Effect of Adjunctive use of Dexmedetomidine and Metoral with Thiopental on Hemodynamic Status, Agitation, and Patient Satisfaction in Patients with Mood Disorders after Electroconvulsive Therapy

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