Systematic review: Electroconvulsive therapy for treatment-resistant mood disorders in children and adolescents

Castaneda-Ramirez, Santiago; Becker, Ted; Bruges-Boude, Adriana; Kellner, Charles H.; Rice, Timothy

doi:10.1007/s00787-022-01942-7

Cited by 25 publications

(17 citation statements)

References 80 publications

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“…31 Finally, a recent meta-analysis evaluated findings using objective scales such as Hamilton or Baker depression scales and found that depressive symptoms in adolescents improved significantly after ECT, with an average HAMD change rate of 63.5%. 32 This study confirmed the effectiveness of ECT in alleviating suicidal ideation in Chinese adolescents with MDD. Therefore, we believe that, in adolescent patients with severe suicidal ideation and a high risk of suicidal behavior, ECT should be considered as the first treatment option.…”

Section: Discussionsupporting

confidence: 73%

“…Other retrospective studies have corroborated the conclusion that ECT reduces suicidal ideation and behavior, while improving overall functioning in adolescent patients 31 . Finally, a recent meta-analysis evaluated findings using objective scales such as Hamilton or Baker depression scales and found that depressive symptoms in adolescents improved significantly after ECT, with an average HAMD change rate of 63.5% 32 . This study confirmed the effectiveness of ECT in alleviating suicidal ideation in Chinese adolescents with MDD.…”

Section: Discussionsupporting

confidence: 68%

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Suicidal Ideation and Electroconvulsive Therapy

Cai

Song

et al. 2023

J ECT

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Objective: Few studies on electroconvulsive therapy (ECT) investigate efficacy and safety on depressive adolescents with strong suicidal ideation. Our study examined adolescents (aged 13-18 years) with major depressive disorder to explore ECT effectiveness in improving suicidal ideation and depressive symptoms, as well as its impact on cognitive function.Methods: This nonrandomized controlled trial enrolled 183 adolescent patients suffering from major depressive disorder. The ECT group (n = 81) was treated with antidepressants and 8 rounds of ECT for 2 weeks. The control group comprised 79 patients treated with antidepressants only. Depressive symptoms, suicidal ideation, and cognitive functions were assessed at baseline (pre-ECT) and at 2 and 6 weeks post-ECT. Results:The ECT group showed significant improvements over control in suicidal ideation from the end of treatment to 6 weeks after (P < 0.001). Depressive symptoms also improved (P < 0.001). Patients treated with ECT demonstrated poorer performance in delayed memory, attention, and language, but these impairments were transient. Thus, ECTwas generally safe in adolescent patients with major depressive disorder.Conclusions: Our findings verified ECT as effective and safe for improving suicidal ideation and depressive symptoms of adolescent patients with major depressive disorder. In addition, partially impaired cognitive function recovered gradually after ECT.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 68%

Suicidal Ideation and Electroconvulsive Therapy

Cai

Song

et al. 2023

J ECT

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“…Both lorazepam and ECT were effective in her case, as is typical in catatonia across the lifespan. Maintenance ECT is a part of her ongoing care plan and has been shown to be an effective and safe intervention for pediatric catatonia including catatonia in autism, without any signs of ensuing neuropsychological impairment 3–5 . There were substantial delays in this case to the successful start of lorazepam (1 year after initial presentation) and ECT (1.5 years after initial presentation).…”

Section: Discussionmentioning

confidence: 90%

Challenges to Electroconvulsive Therapy in Pediatric Catatonia

Hua

Cooper

2023

J ECT

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“…Neuropsychiatric Disease and Treatment 2024:20 1112 equivalent to esketamine: propofol ratio of 0.5:1 or 1:2 can be used for ECT treatment. 8,14,15 However, there are few studies on using intravenous esketamine in ECT treatment. So, we chose esketamine doses of 0.5mg/kg and 0.25mg/kg, which are within the safety range and ensure adequate sedation depth during treatment.…”

Section: Dovepressmentioning

confidence: 99%

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

Chen,

Zhou,

Lan

et al. 2024

NDT

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Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression. Study Design and Methods: This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events. Discussion: This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.

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Systematic review: Electroconvulsive therapy for treatment-resistant mood disorders in children and adolescents

Cited by 25 publications

References 80 publications

Suicidal Ideation and Electroconvulsive Therapy

Suicidal Ideation and Electroconvulsive Therapy

Challenges to Electroconvulsive Therapy in Pediatric Catatonia

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

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