Bitemporal <i>v</i>. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials – CORRIGENDUM

Kolshus, Erik; Jelovac, Ana; McLoughlin, Declan M.

doi:10.1017/s0033291717002720

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“…The role and selection of bilateral and unilateral ECT has become a subject of debate . Our report suggesting a simple new method for eliciting adequate seizures during ECT in high seizure threshold cases may add a new viewpoint to this controversy.…”

Section: Discussionmentioning

confidence: 86%

“…One form of variation is the placement of the electrode, which may be bitemporal, bifrontal, or right unilateral . In general, bilateral (ie, bitemporal and bifrontal) placement is preferred when rapid improvement of clinical symptoms is needed, whereas right unilateral placement is selected in cases where cognitive side effects should be minimized . Furthermore, the intensity of the electric stimulation can be adjusted.…”

Section: Introductionmentioning

confidence: 99%

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When to switch from bilateral to unilateral electroconvulsive therapy: A simple way to elicit seizures in high seizure threshold cases

Eda

Matsuki

2018

Neuropsychopharm Rep

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Aims Although electroconvulsive therapy (ECT) is effective for various psychiatric disorders, its therapeutic effect depends on the occurrence of adequate seizures. Thus, the management of inadequate seizures remains a clinical problem. Here, we aimed to develop a simple method to elicit adequate seizures in high seizure threshold patients during ECT sessions. Methods Right unilateral ECT was performed in 87 sessions (22 inpatients) in which 504 millicoulombs bilateral (bitemporal or bifrontal) electrical stimulation had failed to induce adequate seizures. A Thymatron® System IV (Somatics LLC, Lake Bluff, IL, USA) and the LOW 0.5 program were used in accordance with the manufacturer's instructions. The electrode placement was bitemporal, bifrontal, or right unilateral (d'Elia placement). The minimum duration for an adequate seizure was 15 seconds in the electroencephalogram record of the Thymatron® stimulator. The efficacy of treatment was estimated by the Global Assessment of Functioning at the time of admission and discharge. Cognitive assessment was not performed. Results By switching to right unilateral stimulation immediately after failure of bilateral stimulation, adequate seizures were achieved in 71 of 87 (81.6%) sessions. Improvement in the Global Assessment of Functioning was observed in 23 of 28 (82.1%) treatment courses. Conclusion Switching from bilateral to unilateral electrode placement may be a simple clinical option for eliciting adequate seizures in high seizure threshold cases.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%