Abstract
Objective: The study aimed to test whether there was more rapid response with daily Electroconvulsive Therapy (ECT) (5 times per week right unilateral) and shorter lengths of stay (LOS) without an increase in adverse effects compared to ECT administered in a routine fashion of 2-3 times/week. Methods: This is a retrospective chart review study of inpatient ECT cases performed over a two year period in a general psychiatric unit. Different practitioners used 5 times/week right unilateral (RUL) ECT, 2-3 times/week right unilateral ECT, or bilateral (BL) ECT. All inpatient records of patients, who received inpatient ECT in a general hospital with 80 psychiatric adult beds, were reviewed in the two year study period. Due to a variation in the quality of documentation, the analysis used proxy variables for improvement and side effects of ECT: LOS following the first ECT to discharge, total treatments in the series, and switches in treatment parameters that indicating poor response or adverse effects. Results: 78 patients received inpatient ECT. 35 cases were started with RUL ECT in the standard 3 times/week frequency. 32 cases were started with 5 times/week frequency. 11 cases continued BL ECT placement 3 times per week for a repeat ECT series. Diagnosis was not factor in lead placement or frequency of treatment. 90% of patients had major depression, and 10% were treated for bipolar disorder or schizophrenia. The number of treatments in a successful series was roughly equivalent irrespective of starting lead placement. 5 times/week RUL lead placement did not lead to significant morbidity based on switch rates. The findings show a trend supporting the use of 5 times/ week RUL ECT as a means to shorten the course of ECT without increasing cognitive morbidity.
Highlights
Electroconvulsive Therapy (ECT) remains the most effective treatment for depression and many other major psychiatric disorders
35 cases were started with right unilateral ECT in the standard 3 times/week frequency. 32 cases were started with 5 times/week frequency. 11 cases continued bilateral ECT placement 3 times/week for a recurrent ECT series
The findings showed a trend supporting the use of 5 times / week right unilateral (RUL) ECT as a means to shorten the course of ECT without increasing cognitive morbidity
Summary
Electroconvulsive Therapy (ECT) remains the most effective treatment for depression and many other major psychiatric disorders. ECT has long been associated with complaints of memory dysfunction, risk factors for who will develop post-ictal confusion or long-term memory problems have not been definitively identified [1,2], and seem to be transient. Measurement of cognitive impairment and depression outcomes are still generally measured by global impression of change. In particular is generally measured by meta memory assessment since baseline cognitive function before depression, is not verifiable [7]. Bilateral ECT has consistently been associated with more subjective memory complaints than unilateral ECT, including complaints of persistent memory problems even in the absence of objective cognitive deficits on post-ECT testing [8,9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
