The Effects of Focal Electrically Administered Seizure Therapy Compared With Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy on Suicidal Ideation

Youssef, Nagy A.; George, Mark S.; McCall, W. Vaughn; Sahlem, Gregory L.; Short, Baron; Kerns, Suzanne E. U.; Manett, Andrew J.; Fox, James; Dancy, Morgan; Cook, Daniel; DeVries, William H.; Rosenquist, Peter B.; Sackeïm, Harold A.

doi:10.1097/yct.0000000000000776

Cited by 5 publications

(4 citation statements)

References 56 publications

(91 reference statements)

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“…Further efforts to enhance control over the electrical stimulation site and distribution of electric field in the brain, such as Focal Electrically-Administered Seizure Therapy (FEAST), use specially shaped electrodes that are placed asymmetrically to enhance focal stimulation over the fronto-orbital cortex 63 . Two recent open-label nonrandomized studies, one that assessed cognitive SEs and antidepressant efficacy and a second that looked at the anti-suicidal efficacy of FEAST compared to standard RUL ECT, found similar efficacy and adverse effect profile with slightly better nonsignificant difference in cognitive adverse effect in the FEAST group 64 , 65 .…”

Section: Optimizing Dosing and Administration Of Ectmentioning

confidence: 99%

Recent advances in electroconvulsive therapy in clinical practice and research

Mukhtar¹,

Regenold²,

Lisanby³

2023

Fac Rev

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Electroconvulsive therapy (ECT), the oldest somatic therapy still in use in psychiatry today, remains one of the most effective therapeutic interventions for a wide variety of psychiatric disorders. In this article, we review some of the recent advances in ECT that are currently being researched and implemented in clinical practice. We explore recent studies that point to the potential therapeutic benefit and safety of ECT in COVID-19-related neuropsychiatric complications and special populations (such as the elderly and pregnant persons) that are generally at higher risk of having adverse effects from psychotropic medications. We highlight studies that performed a head-to-head comparison of ECT and ketamine, which has shown promise for treatment-resistant depression and acute suicidality. Researchers continue to explore different ways of using ECT by modifying the treatment parameters to maintain efficacy and decrease side effects. Neurocognitive side effects remain one of the major drawbacks to its use and contribute to the negative stigma of this highly effective treatment. In this regard, we describe attempts to improve the safety of ECT by modifying dosing parameters, novel electrode placements, and the addition of augmenting agents with the aim of decreasing side effects and improving efficacy. This review identifies some of the recent advances in the last few years in ECT research while also highlighting areas where further research is needed.

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Section: Optimizing Dosing and Administration Of Ectmentioning

confidence: 99%

Recent advances in electroconvulsive therapy in clinical practice and research

Mukhtar¹,

Regenold²,

Lisanby³

2023

Fac Rev

View full text Add to dashboard Cite

show abstract

“…FEAST utilizes unidirectional stimulation and an asymmetrical frontal electrode placement with a large posterior electrode (cathode) in front of the right motor cortex and a small anterior electrode (anode) above the center of the right eyebrow, over the right orbitofrontal cortex. This configuration aims to focus seizure induction in the right prefrontal cortex 37–40 …”

Section: Ect—an Ultra-brief Historymentioning

confidence: 99%

Electroconvulsive Therapy: Mechanisms of Action, Clinical Considerations, and Future Directions

Kritzer

Peterchev

Camprodon

2023

Harv Rev Psychiatry

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Learning objectives:• Outline and discuss the fundamental physiologic, cellular, and molecular mechanisms of ECT to devise strategies to optimize therapeutic outcomes• Summarize the overview of ECT, its efficacy in treating depression, the known effects on cognition, evidence of mechanisms, and future directions.AbstractElectroconvulsive therapy (ECT) is the most effective treatment for a variety of psychiatric illnesses, including treatment-resistant depression, bipolar depression, mania, catatonia, and clozapine-resistant schizophrenia. ECT is a medical and psychiatric procedure whereby electrical current is delivered to the brain under general anesthesia to induce a generalized seizure. ECT has evolved a great deal since the 1930s. Though it has been optimized for safety and to reduce adverse effects on cognition, issues persist. There is a need to understand fundamental physiologic, cellular, and molecular mechanisms of ECT to devise strategies to optimize therapeutic outcomes. Clinical trials that set out to adjust parameters, electrode placement, adjunctive medications, and patient selection are critical steps towards the goal of improving outcomes with ECT. This narrative review provides an overview of ECT, its efficacy in treating depression, its known effects on cognition, evidence of its mechanisms, and future directions.

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“…The significant short-and long-term improvement in suicidal ideation also supports previous research on the clinical effects of ECT (Kennedy et al, 2009). In a study using the BSS with patients with a diagnosis of major depressive episodes, it was found both responders and non-responders had a significant improvement in suicidal ideation post-acute-right unilateral ECT treatment (Youssef et al, 2021).…”

Section: Clinical Findingssupporting

confidence: 81%

Neural Mechanisms and Cognitive Outcomes Of Electroconvulsive Therapy: A Transdiagnostic Approach

Watson

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Introduction. Electroconvulsive therapy (ECT) is an effective treatment for severe mental health disorders (e.g., depression, psychosis). However, cognitive side effects and neural mechanisms underlying its therapeutic effect are not well understood. This study aims to probe the mechanisms of ECT using transcranial magnetic stimulation (TMS) and investigate cognitive outcomes in a diverse psychiatric population. Methods. Sixteen individuals receiving ECT completed three assessments (baseline/72-hrs post-/1-month post-ECT). Clinical symptoms were assessed and cognition was measured with the Montreal Cognitive Assessment (MoCA) and ElectroConvulsive therapy Cognitive Assessment (ECCA). Nine of those individuals underwent TMS to probe cortical inhibition and excitation. Results. Clinical symptoms significantly improved following ECT. MoCA scores significantly declined 72-hrs post-ECT, while ECCA scores were unchanged. Cortical inhibition significantly increased post-ECT and was correlated with cognitive and clinical changes. Conclusion. Our findings suggest that cortical inhibition is involved in the mechanisms of ECT and potentially linked to clinical and cognitive outcomes. 2.5.1 Clinical Assessments...……………...………..……………21 2.5.2 Main Clinical Outcome.……………………………….

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The Effects of Focal Electrically Administered Seizure Therapy Compared With Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy on Suicidal Ideation

Cited by 5 publications

References 56 publications

Recent advances in electroconvulsive therapy in clinical practice and research

Recent advances in electroconvulsive therapy in clinical practice and research

Electroconvulsive Therapy: Mechanisms of Action, Clinical Considerations, and Future Directions

Neural Mechanisms and Cognitive Outcomes Of Electroconvulsive Therapy: A Transdiagnostic Approach

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