Electroconvulsive Therapy While Receiving OralAnticoagulation for Deep Venous Thrombosis:Report on Eight Cases and a Review of theLiterature

Hirata, Takayuki; Yasuda, Kazuyuki; Uemura, Tomohiro; Ohtsuki, Masataka; Kobayashi, Keita; Ueda, Tetsuya; Aruga, Yu; Tamaoki, Toshio; Suzuki, Takefumi

doi:10.1016/j.psym.2018.10.007

Cited by 9 publications

(4 citation statements)

References 35 publications

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“… 13 Although no serious adverse events have been reported in patients receiving ECT under anticoagulant therapy in previous studies, the safety of anticoagulant therapy for patients undergoing ECT has not been established because all previous studies were small case series. 29 , 30 Further well-designed studies are warranted to examine the safety of anticoagulants for patients undergoing ECT and the benefits of early initiation of ECT.…”

Section: Discussionmentioning

confidence: 99%

Severity of Depressive Symptoms is Associated with Venous Thromboembolism in Hospitalized Patients with a Major Depressive Episode

Yoshizawa¹,

Takeshima

Ishino³

et al. 2021

NDT

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Purpose A major depressive episode is a risk factor for venous thromboembolism (VTE) in psychiatric inpatients. However, it is unclear whether the severity of depressive symptoms or duration of the current depressive episode is associated with VTE. Further, the VTE prevalence among hospitalized patients with a major depressive episode receiving electroconvulsive therapy is unknown. This retrospective study examined factors associated with VTE among hospitalized patients with a major depressive episode and estimated the prevalence of VTE in such patients who underwent electroconvulsive therapy. Patients and Methods Patients with a major depressive episode hospitalized in the Department of Neuropsychiatry at Akita University Hospital between January 2018 and December 2020 were included. Data from the first week of hospitalization were extracted from medical records. VTE was diagnosed based on the findings of computed tomography. To evaluate whether the severity of depressive symptoms or duration of the current depressive episode was associated with VTE, logistic regression analysis was conducted after adjusting for covariates with known VTE risk factors (antidepressants, antipsychotics, and physical comorbidities). Results We analyzed 133 patients; of these, 14 were diagnosed with asymptomatic VTE. The severity of depressive symptoms (odds ratio: 1.220, 95% confidence interval: 1.081–1.377, p = 0.001) was significantly associated with VTE. The prevalence of VTE among those receiving electroconvulsive therapy was 35% (7/20). Conclusion The prevalence of VTE was 35% among patients receiving in-hospital electroconvulsive therapy for a major depressive episode. VTE should be considered for hospitalized patients with severe depressive symptoms and patients receiving in-hospital electroconvulsive therapy for a major depressive episode.

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Section: Discussionmentioning

confidence: 99%

Severity of Depressive Symptoms is Associated with Venous Thromboembolism in Hospitalized Patients with a Major Depressive Episode

Yoshizawa¹,

Takeshima

Ishino³

et al. 2021

NDT

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“… 15 They are associated with a slightly lower risk of haemorrhage compared with warfarin; hence they are a convenient alternative of treatment. 5 15 Several reports have demonstrated the safety of treatment with these types of anticoagulants. 2 5 10 13 16 17 For instance, a recent case series described eight patients with severe psychiatric conditions who were taking either rivaroxaban, apixaban or edoxaban for DVT.…”

Section: Discussionmentioning

confidence: 99%

“…They were successfully treated with ECT, without major bleeding complications. 5 It is worth noting that no evidence to date reports the optimal duration of anticoagulant treatment before ECT, which should be a focus of attention in further studies.…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive therapy, catatonia, deep vein thrombosis and anticoagulant treatment: a case report

Pérez-Balaguer

Sánchez-Rivero

2021

Gen Psych

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Electroconvulsive therapy (ECT) is considered an effective treatment for pharmacotherapy-resistant severe mental disorders. Catatonia is a complex syndrome characterised by important psychomotor disturbances. Deep vein thrombosis (DVT) and pulmonary embolism (PE) are frequent side effects of prolonged immobility in catatonic patients. Therefore, it is important to resolve the catatonia as soon as possible. ECT is the most effective therapy available and is generally considered a safe procedure. Nevertheless, its use in patients with DVT or PE and anticoagulant treatment remains controversial. We describe a case of a woman in her 40s with a previous diagnosis of bipolar disorder and dysfunctional personality traits. She was hospitalised with persecutory and reference delusions, high emotional lability, anxiety, somatisation and regressive conduct. She later developed catatonic symptoms. No progress was achieved after a month of hospitalisation, despite several pharmacological treatments. She suffered multiple complications of prolonged bedding, such as an extensive DVT of the left common femoral, the external iliac and the common iliac veins. ECT was conducted under treatment with bemiparin. After the third administration, she showed improvement. No major bleeding or PE was developed. The safety of ECT while receiving anticoagulant therapy has been documented, though dosage and type of anticoagulant must be considered. Location of DVT (proximal or distal) may be an important topic to take into account. This report provides further evidence about the efficacy and safety of undergoing ECT in the context of concomitant serious medical conditions, such as DVT and anticoagulant therapy administration.

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“…Another literature review highlights three important points that ECT can be administered safely in the psychiatric patient with catatonia after the occurrence of pulmonary embolism, that is, by evaluation of cardiac function and residual deep venous thrombosis before resuming ECT therapy, adjustment of anticoagulation dose and by adopting preventive measures for recurrent deep venous thrombosis and pulmonary embolism like fluid administration, compression devices and timely ECT [13]. The further literature review also supports the safety of ECT therapy in patients receiving anticoagulants for underlying deep venous thrombosis [14][15][16]. Catatonia with its thromboembolic complication can act as a silent killer and can be easily mistaken for sudden cardiac arrest.…”

Section: Figure 1: Flowsheet Describing the Occurrence Of Thromboembomentioning

confidence: 92%

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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Electroconvulsive Therapy While Receiving OralAnticoagulation for Deep Venous Thrombosis:Report on Eight Cases and a Review of theLiterature

Cited by 9 publications

References 35 publications

Severity of Depressive Symptoms is Associated with Venous Thromboembolism in Hospitalized Patients with a Major Depressive Episode

Severity of Depressive Symptoms is Associated with Venous Thromboembolism in Hospitalized Patients with a Major Depressive Episode

Electroconvulsive therapy, catatonia, deep vein thrombosis and anticoagulant treatment: a case report

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

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