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Electroconvulsive therapy: a review on indications, methods, risks and medication

Published online by Cambridge University Press:  16 April 2020

A Stevens ,
A Fischer ,
M Bartels  and
G Buchkremer
A Stevens
Affiliation:
Department of Psychiatry, University of Tübingen, Osianderstr 22, D-72076Tübingen, Germany
A Fischer
Affiliation:
Department of Psychiatry, University of Tübingen, Osianderstr 22, D-72076Tübingen, Germany
M Bartels
Affiliation:
Department of Psychiatry, University of Tübingen, Osianderstr 22, D-72076Tübingen, Germany
G Buchkremer
Affiliation:
Department of Psychiatry, University of Tübingen, Osianderstr 22, D-72076Tübingen, Germany
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Summary

This paper reviews and presents data of practical impact for those administering electroconvulsive therapy (ECT). In the first section, physical and physiological aspects of the stimulus as well as methods of stimulation are discussed. The second section deals with indications for ECT, efficacy and treatment modalities such as seizure duration, treatment frequency and total number of ECT applications. The last section is devoted to side effects, risks, comedication and comorbidity.

Keywords

ECTelectroconvulsive therapymedicationpredictive factorsdepressionmaniadementia
Type
Review
Information
European Psychiatry , Volume 11 , Issue 4 , 1996 , pp. 165 - 174
Copyright
Copyright © Elsevier, Paris 1996

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References

Abrams, R, Swartz, CM, Vedak, CAntidepressant effects of high-dose right unilateral electroconvulsive therapy Arch Gen Psychiatry 48 1991 746–748CrossRefGoogle ScholarPubMed
Abrams, R, Swartz, CM, Vedak, CAntidepressant effects of right versus left unilateral ECT and the lateralization theory of ECT action Am J Psychiatry 146 1989 1190–1192Google ScholarPubMed
Abrams, R, Taylor, RDiencephalic stimulation and the effects of ECT in endogenous depression Br J Psychiatry 129 1976 482–485CrossRefGoogle ScholarPubMed
Abrams, RClinical prediction of ECT response in depressed patients Psychopharmacol Bull 18 1982 48–50Google ScholarPubMed
Abrams, R2d ed Electroconvulsive Therapy 1992 Oxford University Press OxfordGoogle ScholarPubMed
Abrams, RElectroconvulsive Therapy 1988 Oxford University Press Oxford95–98Google Scholar
Andersen, K, Balldin, J, Gottfries, Cet alA double-blind evaluation of ECT in Parkinson's disease with “on-off” phenomena Acta Neurol Scand 76 1987 191–199CrossRefGoogle ScholarPubMed
Bagadia, VN, Abhyankar, RR, Doshi, J, Pradhan, PV, Shah, LPA double-blind controlled study of ECT vs chlorpromazine in schizophrenia J Assoc Physicians India 31 1983 637–640Google Scholar
Barton, JL, Mehta, S, Snaith, RPThe prophylactic value of ECT in depressive illness Acta Psychiatrica Scand 49 1973 386–392CrossRefGoogle ScholarPubMed
Black, DW, Bell, S, Hulbeert, JThe importance of axis II in patients with major depression J Affective Disord 14 1988 115–122CrossRefGoogle ScholarPubMed
Bolwig, TBlood-brain barrier studies with special reference to epileptic seizures Acta Psychiatrica Scand Suppl 345 1988 15–20Google ScholarPubMed
Brandon, S, Cowley, P, McDonald, C, Neville, P, Palmer, R, Wellstood-Easton, SLeicester ECT trial. Results in schizophrenia Br J Psychiatry 146 1985 177–183CrossRefGoogle Scholar
Chen, JJ, Velamati, S, Stewart, CDetection of prolonged seizure by audible EEG Convulsive Ther 6 1990 248–250Google ScholarPubMed
Coffey, CE, Weiner, RD, Djang, WTet alBrain anatomic effects of ECT: a prospective magnetic resonance imaging study Arch Gen Psychiatry 48 1991 1013–1021CrossRefGoogle ScholarPubMed
Coffey, CE, Wilkinson, WE, Weiner, RDet alQuantitative cerebral anatomy in depression: a controlled magnetic resonance imaging study Arch Gen Psychiatry 50 1993 7–16CrossRefGoogle ScholarPubMed
Crow, TJ, Deakin, JFW, Johnstone, ECThe Northwick Park ECT trial. Predictors of response to real and simulated ECT Br J Psychiatry 144 1984 227–237Google Scholar
Crow, TJ, Johnstone, ECControlled trials of electroconvulsive therapy Ann N Y Acad Sci 462 1986 12–29CrossRefGoogle ScholarPubMed
D'Elia, G, Raotma, HIs unilateral ECT less effective than bilateral ECT? Br J Psychiatry 126 1975 83–89CrossRefGoogle ScholarPubMed
Davis, JM, Janicak, PG, Sakkas, P, Gilmore, C, Wang, ZElectroconvulsive therapy in the treatment of the neuroleptic malignant syndrome Convulsive Ther 7 1991 111–120Google ScholarPubMed
Devanand, DP, Dwork, AJ, Hutchinson, ER, Bolwig, TG, Sackeim, HADoes ECT alter brain structure? Am J Psychiatry 151 1994 957–970Google ScholarPubMed
Dodwell, D, Goldberg, DA study of factors associated with response to electroconvulsive therapy in patients with schizophrenic symptoms Br J Psychiatry 154 1989 635–639CrossRefGoogle ScholarPubMed
Dressier, DM, Folk, JThe treatment of depression with ECT in the presence of brain tumor Am J Psychiatry 132 1975 1320–1321Google Scholar
Fink, MConvulsive Therapy: Theory and Practice 1979 Raven Press New YorkGoogle Scholar
Finlay-Jones, R, Parker, GA consensus conference on psychotic depression Aust-N-Z-J-Psychiatry 27 1993 581–589CrossRefGoogle ScholarPubMed
Flaherty, JA, Naidu, J, Dysken, MECT, emergent dyskinesia, and depression Am J Psychiatry 141 1984 808–809Google ScholarPubMed
Freese, KJCan patients safely undergo electroconvulsive therapy while receiving monoamine oxidase inhibitors? Convulsive Ther 1 1985 190–194Google ScholarPubMed
Gangadhar, BN, Janakiramajah, N, Subbakrishna, DK, Praveen, J, Reddy, AKTwice versus thrice weekly ECT in melancholia: a double-blind prospective comparison Anesth Analg 75 1992 511–514Google Scholar
Gangadhar, BN, Kapur, RL, Kalyanasundaram, SComparison of electroconvulsive therapy with imipramine in endogenous depression: a double-blind study Br J Psychiatry 141 1982 367–371CrossRefGoogle ScholarPubMed
Gilmore, JH, Isley, MR, Evans, DLet alThe reliability of computer-processed EEG in the determination of ECT seizure duration Convulsive Ther 7 1991 166–174Google ScholarPubMed
Greenblatt, M, Grosser, GH, Wechsler, HDifferential response of hospitalized depressed patients in somatic therapy Am J Psychiatry 120 1964 935–943CrossRefGoogle ScholarPubMed
Jeanneau, AElectroconvulsive therapy in the treatment of Parkinson disease Encephale 19 1993 573–578Google ScholarPubMed
Kellner, CH, Monroe, RR, Pritchett, J, Jarrell, MP, Bernstein, HJ, Burns, CMWeekly ECT in geriatric depression Convulsive Ther 8 1992 245–252Google ScholarPubMed
King, JH, Nuss, SReflex sympathetic dystrophy treated by electroconvulsive therapy: intractable pain, depression and bilateral electrode ECT Pain 55 1993 393–396CrossRefGoogle ScholarPubMed
Kolbeinsson, H, Petursson, HElectroencephalographic correlates of electroconvulsive therapy Acta Psychiatrica Scand 78 1988 162–168CrossRefGoogle ScholarPubMed
Kramer, BAUse of ECT in California, 1977–1983 Am J Psychiatry 142 1985 1190–1192Google Scholar
Kramer, BAPoor response to ECT in patients with a combined diagnosis of major depression and personality disorder Lancet 1 1983 1048Google Scholar
Krystal, AD, Weiner, RD, McCall, WVet alThe effects of ECT stimulus dose and electrode placement on the ictal encephalogram: an intraindividual crossover study Biol Psychiatry 34 1993 759–767CrossRefGoogle Scholar
Lambourn, J, Gill, DA controlled comparison of simulated and real ECT Br J Psychiatry 133 1978 514–519CrossRefGoogle ScholarPubMed
Larson, G, Swartz, C, Abrams, RDuration of ECT-induced tachycardia as a measure of seizure length Am J Psychiatry 141 1984 1269–1271Google ScholarPubMed
Lettemendia, FJJ, Delva, NJ, Rodenburg, Met alTherapeutic advantage of bifrontal electrode placement in ECT Psychol Med 23 1993 349–360CrossRefGoogle Scholar
Liberzon, I, deQuardo, JR, Sidell, G, Mazzara, C, Tandon, RPost-ECT dyskinesia Convulsive Ther 7 1991 40–44Google ScholarPubMed
Liston, EH, Guze, BH, Baxter, LR Jr, Richeimer, SH, Gold, MEMotor versus EEG seizure duration in ECT Biol Psychiatry 24 1988 94–96CrossRefGoogle ScholarPubMed
Mander, AJ, Whitfield, A, Kean, D, Smith, MA, Douglas, RH, Kendell, RECerebral an brain stem changes after ECT revealed by nuclear magnetic resonance imaging Br J Psychiatry 151 1987 69–71CrossRefGoogle ScholarPubMed
Markwort, S, Bahro, M, Schmitt, M, Krumm, B, Hewer, WEKT im höheren Lebensalter Fortschr Neurol Psychiat 60 1992 190Google Scholar
McCall, WV, Shelp, FE, Weiner, RD, Austin, S, Harrill, AEffects of labetalol on hemodynamics and seizure duration during ECT Convulsive Ther 7 1991 5–14Google ScholarPubMed
McCall, WV, Shelp, FE, Weiner, RD, Austin, S, Norris, JConvulsive threshold differences in right-unilateral and bilateral ECT Biol Psychiatry 34 1993 606–611CrossRefGoogle ScholarPubMed
Medical Research Council, Clinical trial of the treatment of depressive illness Br Med J 5439 1965 881–886Google Scholar
Meldrum, BSNeuropathological consequences of chemically and electrically induced seizures Ann N Y Acad Sci 462 1986 186–193CrossRefGoogle ScholarPubMed
Miller, LJUse of electroconvulsive therapy during pregnancy Hosp Community Psychiatry 45 1994 444–450Google ScholarPubMed
Mukherjee, S, Sackeim, HA, Schnur, DBElectroconvulsive therapy of acute manic episodes: a review of 50 years experience Am J Psychiatry 151 1994 169–176Google Scholar
Mukherjee, SMechanisms of antimanic effect of electroconvulsive therapy Convulsive Ther 5 1989 227–243Google ScholarPubMed
Murray, GB, Shea, V, Conn, DKElectroconvulsive therapy for poststroke depression J Clin Psychiatry 47 1986 258–260Google ScholarPubMed
Nobler, MS, Sackeim, HA, Solomou, M, Luber, B, Devanand, DP, Prudic, JEEG Manifestations during ECT: Effects of electrode placement and stimulus intensity Biol Psychiatry 34 1993 321–330CrossRefGoogle ScholarPubMed
Ottoson, JOExperimental studies of the mode of action of electroconvulsive therapy Acta Psychiatrica et Neurologica Scandinavica Suppl 145 1960 1–141Google Scholar
Penney, JF, Dinwiddie, SH, Zorumski, CF, Wetzel, RDConcurrent and close temporal administration of lithium and ECT Convulsive Ther 6 1990 139–145Google ScholarPubMed
Perry, SWHIV-related depression Res Publ Assoc Res Nerv Ment Dis 72 1994 223–236Google ScholarPubMed
Petrides, G, Dhossche, D, Fink, M, Francis, AContinuation ECT: Relapse prevention in affective disorders Convuls Ther 10 1994 189–194Google ScholarPubMed
Post, RM, Uhde, TW, Rubinow, DRDifferential time course for antidepressant effects after sleep deprivation, ECT and carbamazepine: clinical and theoretical implications Psychiatry Res 22 1987 11–19CrossRefGoogle ScholarPubMed
Price, RF, Mackenzie, TB, Ticker, GJ, Culver, CThe dose-response ratio in ECT Arch Gen Psychiatry 35 1978 1131–1136CrossRefGoogle Scholar
Prudic, J, Sackeim, HA, Devanand, DPMedication resistance and clinical response to electroconvulsive therapy Psychiatry Res 31 1990 287–296CrossRefGoogle ScholarPubMed
Richard, CL, Black, NAThe efficacy of ECT: II. Correlation of specific treatment variables to response rate in unilateral ECT Psychiatry Res 16 1985 147–154Google Scholar
Rifkin, AECT versus tricyclic antidepressants in depression: a review of the evidence J Clin Psychiatry 49 1988 3–7Google Scholar
Rodger, CR, Scott, AI, Whalley, LJIs there a delay of the antidepressant effect of electroconvulsive therapy? Br J Psychiatry 164 1994 106–109CrossRefGoogle Scholar
Sackeim, HA, Decina, P, Kanzler, M, Kerr, B, Malitz, SEffects of electrode placement on the efficacy of titrated, low dosage ECT Am J Psychiatry 144 1987 1449–1455Google Scholar
Sackeim, HA, Decina, P, Portnoy, S, Neeley, P, Malitz, SStudies of dosage, seizure threshold and seizure duration in ECT Biol Psychiatry 22 1987 249–268CrossRefGoogle ScholarPubMed
Sackeim, HA, Devanand, DP, Prudic, JStimulus intensity, seizure threshold and seizure duration: Impact on the efficacy and safety of electroconvulsive therapy Psychiatry Clin N America 14 1991 803–843CrossRefGoogle ScholarPubMed
Sackeim, HA, Prudic, J, Devanand, DP, Decina, P, Kerr, B, Malitz, SThe impact of medication resistance and continuation pharmacotherapy on relapse following response to electroconvulsive therapy in major depression J Clin Psychopharmacol 10 1990 96–104CrossRefGoogle ScholarPubMed
Sackeim, HA, Prudic, J, Devanand, DPet alEffects of stimulus intensity and electrode placements on the efficacy and cognitive effects of electroconvulsive therapy N Engl J Med 328 1993 839–846CrossRefGoogle Scholar
Sackeim, HAUse of ECT in late-life depressionSchnei der, LSReynolds, CF IIILebowitz, BDFriedhoff, AJDiagnosis and Treatments of depression in Late-Life 1994 American Psychiatric Press Washington DC259–277Google Scholar
Scott, AI, Turnbull, LWDo repeated courses of ECT cause brain damage detectable by MRI? Am J Psychiatry 147 1990 371–372Google ScholarPubMed
Scott, AI, Douglas, RH, Whitfield, A, Kendell, RETime course of cerebral magnetic resonance changes after electroconvulsive therapy Br J Psychiatry 156 1990 551–553CrossRefGoogle ScholarPubMed
Shapira, B, Valev, A, Lerer, BTwice vs three times weekly ECT: Results of the Jerusalem double-blind study 1 : Clinical Outcome measures (abstract) Convulsive Ther 8 1992 77Google Scholar
Skoog, IThe prevalence of psychotic, depressive and anxiety syndromes in demented and non-demented elderly J Geriatr Psychiatry 8 1993 247–253CrossRefGoogle Scholar
Stein, GDrug treatment of the personality disorders Br J Psychiatry 161 1992 167–174CrossRefGoogle ScholarPubMed
Stoudemire, A, Hill, CD, Morris, R, Martino-Salzman, D, Lewison, BLong term affective and cognitive outcome in depressed older adults Am J Psychiatry 150 1993 896–900Google ScholarPubMed
Stoudemire, A, Knos, G, Gladson, M, Markwalter, H, Sung, YF, Morris, R, Cooper, RLabetalol in the control of cardiovascular responses to electroconvulsive therapy in high-risk depressed medical patients J Clin Psychiatry 51 1990 508–512Google ScholarPubMed
Swartz, CM, Larson, GECT stimulus duration and it's efficacy Ann Clin Psychiatry 1 1989 147–152CrossRefGoogle Scholar
Taylor, P, Fleminger, JJECT for schizophrenia Lancet 1 1980 1380–1382CrossRefGoogle Scholar
Taylor, PJ, von, Witt RJ, Fry, AHSerum creatine phosphokinase activity in psychiatric patients receiving ECT J Clin Psychiatry 42 1981 103–105Google Scholar
Teri, L, Wagner, AAlzheimer's disease and depression J Consult Clin Psychol 60 1992 379–391CrossRefGoogle ScholarPubMed
Tyrer, P, Casey, P, Gall, JRelationship between neurosis and personality disorder Br J Psychiatry 142 1983 404–408CrossRefGoogle ScholarPubMed
Vanelle, JM, Loo, H, Galinowski, Aet alMaintenance ECT in intractable manic-depressive disorders Convuls Ther 10 1994 195–205Google ScholarPubMed
Volavka, J, Feldstein, S, Abrams, R, Fink, MEEG and clinical change after bilateral and unilateral electroconvulsive therapy Electroencephalogr Clin Neurophysiol 32 1972 631–639CrossRefGoogle ScholarPubMed
Webb, MC, Coffey, CE, Saunders, WRet alCardiovascular response to unilateral electroconvulsive therapy Biol Psychiatry 28 1990 758–766CrossRefGoogle ScholarPubMed
Weiner, RD, Rogers, HJ, Squire, LREffects of stimulus parameters on cognitive side effects Ann N Y Acad Sci 462 1986 315–325CrossRefGoogle ScholarPubMed
Weiner, RDDoes electroconvulsive therapy cause brain damage? Behav Brain Sci 7 1984 1–53CrossRefGoogle Scholar
Weinger, MB, Partridge, BL, Hauger, R, Mirow, APrevention of the cardiovascular and neuroendocrine response to electroconvulsive therapy: I. Effectiveness of pretreatment regimens on Anesth Analgesia 73 1991 556–562CrossRefGoogle Scholar
Welch, CA, Drop, LJCardiovascular effects of ECT Convulsive Ther 5 1989 35–43Google ScholarPubMed
Wells, DG, Davies, GG, Rosewarne, FAttenuation of electroconvulsive therapy induced hypertension with sublingual nifedipine Anesthesia Intensive Care 17 1989 31–33CrossRefGoogle ScholarPubMed
Wilkinson, AM, Anderson, DN, Peter, SAge and the effects of ECT Int Geriatr Psychiatry 8 1993 401–406CrossRefGoogle Scholar
Zervas, IM, Calev, A, Jandorv, Let alAge dependent effects of electroconvulsive therapy on memory Convulsive Ther 9 1993 39–42Google ScholarPubMed
Zielinsky, RJ, Rose, SP, Devanand, DP, Woodring, S, Sackeim, HACardiovascular Complications of ECT in depressed patients with cardiac disease Am J Psychiatry 150 1993 904–909Google Scholar
Zimmermann, M, Coryell, W, Pfohl, B, Corenthal, C, Stangl, DECT response in depressed patients with and without a DSM-III-R personality disorder Am J Psychiatry 143 1986 1030–1032Google Scholar
Zornberg, GL, Pope, HG JrTreatment of depression in bipolar disorder: new directions for research J Clin Psychopharmacol 13 1993 397–408CrossRefGoogle ScholarPubMed
Zwil, AS, McAllister, TW, Price, TRSafety and efficacy of ECT in depressed patients with organic brain disease: review of a clinical experience Convulsive Ther 8 1992 204–210Google ScholarPubMed
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