A Psychiatric Patient With Catatonia and Pulmonary Thromboemboli

Hamdieh, Mostafa; Safaie, Nilufar; Abbasinejad, Maryam

doi:10.1176/appi.neuropsych.13010004

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Catatonia with its thromboembolic complication can act as a silent killer and can be easily mistaken for sudden cardiac arrest. It is, therefore, very important to diagnose these lethal complications in a catatonic patient early on in the course of illness [17]. The literature also emphasizes the importance of early diagnosis of catatonia and its treatment with ECT to prevent life-threatening complications.…”

Section: Figure 1: Flowsheet Describing the Occurrence Of Thromboembomentioning

confidence: 99%

Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient

Warriach

Shamim

Saeed

et al. 2019

Cureus

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Catatonia is a condition in which patients manifest with a complex of symptoms of behavioral and motor abnormalities. This condition can present with schizophrenia, bipolar, depression, and certain neurological illnesses. In this article, we analyze the coincidence of deep venous thrombosis (DVT) in schizophrenia with catatonia patients managed with electroconvulsive therapy (ECT) and the possible outcome of complications as an adverse event. The conclusion drawn from this traditional review reveals the importance of early diagnosis and treatment intervention of catatonia patients with ECT. No bleedingrelated complications occurred with the use of anticoagulants by catatonic patients managed with ECT and having underlying thrombosis. Literature also indicates that ECT can be safely administered for patients with distal deep venous thrombosis (DVT) treated with anticoagulants, while those with proximal DVT, ECT should be halted and anticoagulation treatment should be continued until the resolution of DVT to safely resume the ECT sessions. A possible alternative to ECT therapy for the patients with refractory schizophrenia with catatonia (who have safety concerns) is recombinant transcranial magnetic stimulation (rTMS). Nonetheless, more studies are needed to support our assertion.

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Section: Figure 1: Flowsheet Describing the Occurrence Of Thromboembomentioning

confidence: 99%

Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient

Warriach

Shamim

Saeed

et al. 2019

Cureus

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“…One proposed mechanism involves the mobilization of an already formed DVT secondary to muscle contraction as of a result of the seizure elicited during the ECT. 6 There have been at least 2 reports 7,8 of PE occurring during ECT treatment, 1 of which was fatal. In an analysis 9 of 8 patients receiving concomitant ECT and either edoxaban or apixaban for an acute DVT, 1 patient (12.5%) developed a PE during ECT.…”

Section: Introductionmentioning

confidence: 99%

Safety of ECT in patients receiving an oral anticoagulant

Centanni¹,

Craig

Whitesell

et al. 2021

Mental Health Clinician

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Introduction This study assessed the use, tolerability, and safety of anticoagulation via direct oral anticoagulants or warfarin in medical and psychiatric inpatients receiving ECT. Methods This retrospective cohort study included 32 patients who received ECT while on either a direct oral anticoagulant (9) or warfarin (23) and spanned 247 encounters at Maine Medical Center between December 2012 and December 2018. Data are presented descriptively and analyzed using SPSS version 25 and Microsoft Excel version 2016. Results Among the 247 ECT patient encounters, there were few major adverse effects of ECT in this medically complex population. These adverse effects included headache during 4 encounters (1.6%), respiratory distress during 2 encounters (0.8%) and a cardiovascular event during 1 encounter (0.4%). One patient (3.1%) who was receiving concurrent rivaroxaban and venlafaxine experienced gastrointestinal bleeding that was determined to be unrelated to ECT. One patient on fluoxetine and warfarin experienced hemoptysis thought to be secondary to epistaxis. No other major bleeding or clotting event occurred during an ECT session nor for the duration of the hospitalization. Discussion Direct oral anticoagulants and warfarin appear safe in the treatment of patients with atrial fibrillation or acute venous thromboembolism who are receiving concomitant ECT. Prospective studies are needed to confirm these findings.

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A Psychiatric Patient With Catatonia and Pulmonary Thromboemboli

Cited by 2 publications

References 12 publications

Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient

Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient

Safety of ECT in patients receiving an oral anticoagulant

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