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The aim of the study was to assess efficacy and safety of electroconvulsive therapy.43 patients included into the study were hospitalised in The Institute of Psychiatry and Neurology and received all together over 400 bilateral electroconvulsive procedures. Most of the patients (N = 25) were qualified for electroconvulsive therapy due to treatment resistant depression (58.1%). Six patients: 2 with catatonia and 4 with depression had life saving indications for electroconvulsive therapy. Three patients (7%) were excluded from electroconvulsive therapy, following 1 or 2 electroconvulsive procedures. Forty patients continued electroconvulsive therapy.There were no complications and serious adverse events in patients who continued electroconvulsive therapy. Generally, electroconvulsive therapy was well tolerated and treatment had been cut down in only one case due to adverse events and high risk related to the procedure. Transient cardiac arrhythmias (10% of patients) were the most often occurring adverse events and patients (35%) mostly reported headaches. We observed remission in 22 patients (58%) and improvement in 14 patients (35%) following electroconvulsive treatment. Only 4 patients (10%) had no benefit after a series of electroconvulsive procedures. Electroconvulsive treatment was most effective in patients with catatonia (80% patients had full recovery) and in depressive patients with bipolar disorder (73% patients had full recovery).Electroconvulsive procedures were safe and effective. Electroconvulsive treatment was most effective in catatonic patients with schizophrenia and in depressive patients with bipolar disorder.
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Electroconvulsive therapy has been described as a mood stabilizer, as it is effective in all stages of bipolar disorder. Electroconvulsive therapy–induced mania is a known and potentially dangerous risk of treating bipolar depression with electroconvulsive therapy and there are no established guidelines for the management of electroconvulsive therapy–induced mania. We report a case of electroconvulsive therapy–induced mania where electroconvulsive therapy was continued as the sole, effective antimanic agent, which is the first described case in literature.
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Objective: The efficacy of electroconvulsive therapy in treating depressive symptoms has been established by means of innumerable studies developed along the last decades. Electroconvulsive therapy is the most effective biological treatment for depression currently available. The objective of this study was to demonstrate the role of electroconvulsive therapy in the treatment of depression and highlight present aspects related to its practice. Method: We reviewed in the literature studies on efficacy, symptom remission, predictive response factors as well as current aspects regarding quality of life, the patients’ perception, mechanism of action, technique and cognitive impairment. Results: The main results found in the this revision were: 1) electroconvulsive therapy is more effective than any antidepressant medication; 2) the remission of depression with electroconvulsive therapy varies, in general, from 50 to 80%; 3) The effect of electroconvulsive therapy in brain-derived neurotrophic factor levels is still controversial; 4) electroconvulsive therapy has a positive effect in the improvement of quality of life; 5) patients submitted to electroconvulsive therapy have, in general, a positive perception about the treatment. Conclusion: Electroconvulsive therapy remains a highly efficacious treatment in treatment-resistant depression. With the improvement of its technique, electroconvulsive therapy has become an even safer and more useful procedure both for the acute phase and for the prevention of new depressive episodes. Descriptors: Electroconvulsive therapy; Brain-derived neurotrophic factor; Depression; Quality of life; Treatment outcome
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Article Abstract Objective: To assess the efficacy of electroconvulsive therapy (ECT) in DSM-5 obsessive-compulsive-related disorders (OCRDs) and conditions subsumed under an "extended" OCD spectrum, including tic disorders and self-injurious behaviors. Data Sources: A systematic search of the MEDLINE, Web of Science, Scopus, and LILACS databases and other sources was performed between June 6 and July 2, 2017. Search terms included (Autis*) AND (ECT OR electroconvulsive), (Self-injur*) AND (ECT OR electroconvulsive), (Tic* OR Tourette) AND (ECT OR electroconvulsive), (Body Dysmorphic Disorder OR Dysmorphophobi*) AND (ECT OR electroconvulsive), (Hoard*) AND (ECT OR electroconvulsive), (Trichotillomani*) AND (ECT OR electroconvulsive), (Skin Picking OR Excoriation) AND (ECT OR electroconvulsive), (Grooming) AND (ECT OR electroconvulsive), (Kleptomani*) AND (ECT OR electroconvulsive), and (Pyromani*) AND (ECT OR electroconvulsive). No search restrictions (ie, date, language, or document type) were used. Study Selection: Fifty-two records that described the individual responses of OCRDs to ECT (involving 69 patients) were selected. Data Extraction: Clinical data and responses of individual cases were recorded. Data from responders were compared to nonresponders. Results: All records were case reports or case series; there were no randomized controlled trials. Of the 69 OCRD participants who had undergone ECT, a positive response was reported in 73.4% of the cases (including 44.0% of the BDD, 74.1% of the tic disorder, and 85.7% of the self-injurious behavior patients). At follow-up, the majority of responders who had abstained from further ECT had experienced relapse. However, a positive response was obtained in all participants who received a new course of ECT. Patients who responded positively to ECT were likely to report previous unsuccessful treatment with antipsychotics (P < .001) and antidepressants (P = .007). Conclusions: The finding that more than 70% of the reviewed cases showed some response to ECT should not be considered unequivocal evidence of its efficacy in OCRDs. The available evidence suggests that a randomized controlled trial of ECT in OCRDs may be warranted, particularly in severe tic disorders and self-injurious behaviors.
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Electroconvulsive therapy is a method of treating mental disorders that is still used today. It is thanks to electroconvulsive therapy that high rates of remission are achieved in patients. The main clinical indications for electroconvulsive therapy are severe depression with a high risk of suicide, life-threatening somatic conditions due to depression. Electroconvulsive therapy is usually used in the first and second trimesters of pregnancy as a last-line method of choice if there are convincing indications for its administration, to quickly eliminate the symptoms. When performing electroconvulsive therapy, the risks of using anesthesia, side effects, severity of the somatic condition, as well as the risks of not using this therapy are evaluated. Although electroconvulsive therapy is considered to be a safe and effective method for treating mental patients if necessary measures are taken to reduce potential risks, it is extremely rarely used to treat women with mental disorders during pregnancy and the postpartum period.
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Objective: Gender difference is a significant determinant of treatment response. As in pharmacological agents, knowledge about this difference is also important for electroconvulsive therapy as an effective treatment modality. The current study aimed to examine the gender differences in terms of indications for electroconvulsive therapy, responses to treatment, and side effects that occur during its application.Methods: The hospital records of 176 adult patients (39 females and 137 males) having undergone bilateral temporal electroconvulsive therapy under anesthesia between 2007 and 2012 were examined retrospectively.Results: The mean age of women was higher than that of men, and the duration of hospitalization was longer in men. There was a significant difference between the genders in terms of the indications of electroconvulsive therapy. Major depression as a diagnosis and suicidal thoughts as an indication were more common in women, while catatonia was more common in men. The most frequent side effects were cardiovascular side effects and allergic reactions. No significant difference was determined in the response rates of the patients to electroconvulsive therapy according to their diagnosis and genders.Conclusion: Our results once again demonstrated that electroconvulsive therapy is a highly effective treatment in both genders. Some gender differences exist in terms of indication and diagnosis, although there was no difference in terms of response to electroconvulsive therapy. There is a need for prospective studies to identify the reasons for these differences.
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