What I would say to a patient who asked me about this article

2006 ◽  
Vol 12 (3) ◽  
pp. 237-238 ◽  
Author(s):  
Allan Scott
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
Clinical Improvement ◽  
Treatment Option ◽  
Electroconvulsive Therapy ◽  
Depressive Illness

Electroconvulsive therapy (ECT) remains an important treatment option for severe depressive illness, but it can have side-effects, including permanent gaps in memory. Where minimising the intellectual side-effects of treatment has priority, then treatment to only one side of the head (unilateral ECT) is preferable; where the speed of clinical improvement is paramount, then bilateral ECT may be preferred. The choice of how ECT is administered should, where possible, be part of the process of informed consent.

Does psychosis predict response to ECT in depressed elderly patients?

1999 ◽  
Vol 16 (1) ◽  
pp. 13-15
Author(s):  
Niall Gormley ◽  
Con Cullen ◽  
Liam Watters ◽  
Michael Philpot ◽  
Brian A Lawlor
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Treatment Option ◽  
Electroconvulsive Therapy ◽  
Therapy Response ◽  
Psychiatric Hospitals ◽  
Depressive Illness ◽  
Response To Treatment ◽  
Depressed Patients

AbstractObjectives: To compare the electroconvulsive therapy response of a sample of depressed elderly patients as a function of the presence or absence of psychosis.Method: Retrospective study of patients over age 65 treated with ECT at three psychiatric hospitals over a three year period.Results: One hundred and eighty-nine ECT courses were administered to 135 patients. Almost 8 5% of patients made a marked or moderately good response to treatment. There was no difference in ECT response between psychotic and non-psychotic depressed patients.Conclusions: ECT should be considered as a treatment option for severe depressive illness, regardless of depressive subtype.

Current Issues in Electroconvulsive Therapy

1987 ◽  
Vol 60 (3) ◽  
pp. 747-758 ◽  
Author(s):  
John R. Taylor ◽  
James L. Carroll
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
Major Depression ◽  
Health Risks ◽  
Electroconvulsive Therapy ◽  
Recent Treatment ◽  
History Of

Contemporary medical and legal trends in electroconvulsive therapy (ECT) are presented. The history of ECT, underlying neurophysiological theory, recent treatment developments, potential side effects and health risks, and contrasting views between the proponents and opponents are examined. Issues involving informed consent and psychotherapy are also discussed. The analysis recognizes ECT's documented record in treating major depression but calls for further stringent research to validate its efficacy.

scholarly journals Onset of clinical improvement of depressive illness following electroconvulsive therapy

1999 ◽  
Vol 23 (8) ◽  
pp. 474-477 ◽  
Author(s):  
Laofe Oladele Ogundipe ◽  
Mike Jorsh ◽  
B. Wain ◽  
J. Lea
Keyword(s):  
Clinical Improvement ◽  
Electroconvulsive Therapy ◽  
Depressive Illness ◽  
Clinical Implications ◽  
Prospective Design ◽  
Global Improvement

Aims and methodTo examine the onset and course of clinically observable improvement in patients receiving electroconvulsive therapy (ECT). A prospective design was used In which 19 consecutive patients receiving ECT were followed up from commencement to termination of ECT. The Clinical Global Improvement Scale was administered at every ECT session to monitor their Improvement.ResultsEleven of the 19 subjects Improved minimally and another subject Improved substantially after the first two ECT treatments.Clinical implicationsECT produces clinically observable improvement in depression within a few days of starting treatment perhaps earlier than is generally acknowledged.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

When should ECT be used?

1977 ◽  
Vol 15 (1) ◽  
pp. 2-4
Keyword(s):  
Electroconvulsive Therapy ◽  
Mode Of Action ◽  
Depressive Illness ◽  
Muscle Relaxants ◽  
House Of Commons ◽  
Mode Of Administration ◽  
Lay People ◽  
Harmful Effects

Though electroconvulsive therapy (ECT) has been widely used in depressive illness for over 30 years, its use is empirical, its mode of action remains unknown, and some medical and lay people have asserted that its dangers outweigh its usefulness. Over the years the mode of administration has gradually changed with the introduction of anaesthetics and muscle relaxants. The number of shocks in a course of ECT has tended to lessen and unilateral ECT has some advantages.1 Nevertheless, recently the long-standing controversy on its use has increased. In some states in America legislation has been introduced to restrict it2 and questions on its possible harmful effects have been asked in the House of Commons.3

Subjective Side-Effects of ECT

1975 ◽  
Vol 127 (6) ◽  
pp. 609-611 ◽  
Author(s):  
Joan Gomez
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Memory Impairment ◽  
Consecutive Series ◽  
Subjective Memory ◽  
Subjective Memory Impairment ◽  
Physical Threat ◽  
Permanent Memory ◽  
Subjective Side

SummaryThe incidence of side-effects present 24 hours after electroconvulsive therapy was studied in 96 patients who between them received 500 treatments in a consecutive series. None of the side-effects occurred frequently: headache was experienced after 2·6 per cent and subjective memory impairment after 3 per cent of treatments. None of the unwanted effects held any serious physical threat. The aspect of ECT most disliked by the patients in this study, and mentioned by 16 per cent of them, was the fear of permanent memory upset.

scholarly journals Alfentanil anesthetic augmentation lengthens seizure duration in electroconvulsive therapy with older people

2016 ◽  
Vol 28 (6) ◽  
pp. 1051-1052
Author(s):  
Craig D'Cunha ◽  
Christos Plakiotis ◽  
Daniel W. O'Connor
Keyword(s):  
Side Effects ◽  
Older People ◽  
Electroconvulsive Therapy ◽  
Electrode Placement ◽  
Seizure Threshold ◽  
Dose Titration ◽  
Seizure Duration ◽  
New Learning ◽  
Prescription Rates ◽  
Cognitive Side Effects

Electroconvulsive therapy (ECT) prescription rates rise with age, making it important that treatments be made as effective and safe as possible (Plakiotis et al., 2012). Older people are vulnerable to post-treatment confusion and to subsequent deficits in attention, new learning, and autobiographical memory (Gardner and O'Connor, 2008). Strategies to minimize cognitive side-effects include unilateral electrode placement and stimulus dose titration whereby electrical charge is individually calibrated to seizure threshold (Sackeim et al., 2000). It remains the case, however, that threshold levels typically rise over the treatment course, leading to an increase both in delivered charge and the risk of adverse sequelae.

scholarly journals Dietary Management of Children With Super-Refractory Status Epilepticus: A Systematic Review and Experience in a Single UK Tertiary Centre

2021 ◽  
Vol 12 ◽  
Author(s):  
Natasha E. Schoeler ◽  
Zoe Simpson ◽  
Runming Zhou ◽  
Suresh Pujar ◽  
Christin Eltze ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Side Effects ◽  
Treatment Option ◽  
Causal Effect ◽  
Refractory Status Epilepticus ◽  
Epilepsy Syndrome ◽  
Drug Resistant ◽  
Street Hospital ◽  
Adverse Side Effects ◽  
Refractory Status

Ketogenic diet therapies (KDT) are high-fat, low carbohydrate diets used as an effective treatment option for drug-resistant epilepsy. There is limited research on the efficacy of KDT for super-refractory status epilepticus (SRSE). We systematically review evidence for use of KDT in children with SRSE and present a single UK tertiary centre's experience. Thirty one articles were included, of which 24 were “medium” or “low” quality. One hundred and forty seven children with SRSE started KDT, of which 141 (96%) achieved ketosis. KDT was started mean 5.3 days (range 1–420) after status epilepticus (SE) started. SRSE resolved in 85/141 (60%) children after mean 6.3 days (range 0–19) post SE onset, but it is unclear whether further treatments were initiated post-KDT. 13/141 (9%) children died. Response to KDT was more likely when initiated earlier (p = 0.03) and in females (p = 0.01). Adverse side effects were reported in 48/141 (34%), mostly gastrointestinal; potentially serious adverse effects occurred in ≤4%. Eight children with SRSE, all diagnosed with febrile infection-related epilepsy syndrome, were treated with KDT at Great Ormond Street Hospital for Children. KDT was initiated enterally at mean day 13.6+/− 5.1 of admission. Seven of 8 (88%) children reported adverse side effects, which were potentially serious in 4/8 (50%), including metabolic acidosis, hypoglycaemia and raised amylase. SE ceased in 6/8 (75%) children after mean 25+/− 9.4 days post onset, but other treatments were often started concomitantly and all children started other treatments post-KDT. Two of 8 (25%) children died during admission and another died post-admission. Four of the remaining 5 children continue to have drug-resistant seizures, one of whom remains on KDT; seizure burden was unknown for one child. Our findings indicate that KDT is possible and safe in children with SRSE. Cessation of SRSE may occur in almost two-thirds of children initiated with KDT, but a causal effect is difficult to determine due to concomitant treatments, treatments started post-KDT and the variable length of time post-KDT onset when SRSE cessation occurs. Given that serious adverse side effects seem rare and response rates are (cautiously) favorable, KDT should be considered as an early treatment option in this group.

scholarly journals Periodontal plastic surgery for treatment of gummy smile with cosmetic restauration treatment

RSBO ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 50
Author(s):  
Keith Jimmy Gonçalves ◽  
Gabrielle Gobbo Agnoletto ◽  
Leonardo Fernandes Da Cunha ◽  
Carmen Mueller Storrer ◽  
Tatiana Miranda Deliberador
Keyword(s):  
Mental Health ◽  
Case Report ◽  
Side Effects ◽  
Plastic Surgery ◽  
Treatment Option ◽  
Restorative Dentistry ◽  
Physical And Mental Health ◽  
Aesthetic Dentistry ◽  
Periodontal Plastic Surgery ◽  
Gummy Smile

Introduction: Today, the appreciation of aesthetic dentistry by society brought to the search for materials and techniques that improve the appearance of smile, which is essential in maintaining physical and mental health of the patient. Objective: This study aimed to report a case of gummy smile involving Periodontics and Restorative Dentistry. Case report: This case, despite other possible alternatives, was solved through periodontal surgery (clinical crown augmentation associated with osteotomy) and indirect restorations with porcelain crowns. Conclusion: In our experience this procedure is safe, predictable, with minimal risks or side effects, and it is a treatment option for these cases.

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