Fractures in Electroshock Therapy as Related to Roentgenographic Spinal Findings

Huddleson, James H.; Gordon, H. McL.

doi:10.1093/milmed/98.1.38

Cited by 2 publications

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“…For example, Caplan[80] described the administration of 1183 unmodified ECTs across 3-17 months to 25 patients; routine X-rays obtained before and after ECT identified no case of vertebral fracture. Huddleson and Gordon[81] reported a fracture risk of only 6.3%; and Worthing and Kalinowsky[82] reported a risk of only 10%In a small, retrospective chart review, Mukherjee and Debsikdar[83] found complete or almost complete remission of mania in 30 patients treated with an average of 5.4 unmodified ECTs. No patient had post-ictal confusion and no fractures or dislocations were documented…”

Section: Musculoskeletal Complications Of Unmodified Ectmentioning

confidence: 99%

Section: Musculoskeletal Complications Of Unmodified Ectmentioning

confidence: 99%

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Position statement and guidelines on unmodified electroconvulsive therapy

Andrade

Shah

Tharyan

et al. 2012

Indian J Psychiatry

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Background:In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of unmodified ECT in developing countries and, to a small extent, in the developed world, as well.Materials and Methods:This document examines historical and recent literature on the geographical practice, physiology, efficacy, and adverse effects of unmodified ECT. Particular attention is paid to musculoskeletal risks.Results:Although almost all the research is of poor methodological quality, there is a good reason to accept that unmodified ECT is associated with a wide range of adverse consequences, important among which are musculoskeletal complications, pre-ECT anxiety, and post-ECT confusion. However, it appears from recent data that these risks are not as large as historically portrayed. Possibly explanations are suggested, with seizure modification using parenteral benzodiazepines as a special possibility.Conclusions:Under exceptional circumstances, if ECT is strongly indicated and seizure modification with succinylcholine is not feasible, unmodified ECT, especially benzodiazepine-modified ECT, may be a viable option. A detailed set of recommendations for such use of unmodified ECT is proposed along with necessary checks and balances. This document has been approved by the Indian Psychatric Society, the Indian Association of Biological Psychiatry, and the Indian Association of Private Psychiatry (which commissioned the preparation of the document).

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Section: Musculoskeletal Complications Of Unmodified Ectmentioning

confidence: 99%

Section: Musculoskeletal Complications Of Unmodified Ectmentioning

confidence: 99%

Position statement and guidelines on unmodified electroconvulsive therapy

Andrade

Shah

Tharyan

et al. 2012

Indian J Psychiatry

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Clarification of the Problem of Vertebral Fractures from Convulsive Therapy

Newbury¹,

Etter²

1955

AMA Arch NeurPsych

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The problem of clinically significant skeletal complications resulting from convulsive therapy continues to warrant careful study. This has been amply substantiated within the past three years by the development of new muscle-relaxant drugs1 and the necessity for standards relating to medicolegal aspects.* It is our purpose in this section of our paper to review the literature relating to the incidence of such complications, with special reference to vertebral fractures. The emphasis on vertebral fractures is dictated by the wealth of material, the wide range in reported incidence, and the apparent lack of agreement in discussions relating to mechanisms of production and methods of prevention. In contrast, there are relatively few studies dealing with the incidence of other skeletal complications. Perhaps the problem here is clear cut. Dislocations and fractures (other than vertebral) are generally diagnosed with less difficulty and usually necessitate immediate treatment, and the clinical significance is unquestioned.

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Fractures in Electroshock Therapy as Related to Roentgenographic Spinal Findings

Cited by 2 publications

References 0 publications

Position statement and guidelines on unmodified electroconvulsive therapy

Position statement and guidelines on unmodified electroconvulsive therapy

Clarification of the Problem of Vertebral Fractures from Convulsive Therapy

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