Improvement of postpartum depression and psychosis after electroconvulsive therapy: A population-based study with a matched comparison group

Rundgren, Sara; Brus, Ole; Båve, Ullvi; Landén, Mikael; Lundberg, J.; Nordanskog, Pia; Nordenskjöld, Axel

doi:10.1016/j.jad.2018.04.043

Cited by 46 publications

(35 citation statements)

References 39 publications

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“…(54,55,58,(61)(62)(63). In stark contrast with these guidelines, the National Institute for Health and Care Excellence (NICE) states that ECT should only be used 'to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening, in individuals with severe depressive illness, catatonia, or a prolonged or severe manic episode' (56).…”

Section: Pregnancy and Postpartummentioning

confidence: 99%

When to consider electroconvulsive therapy (ECT)

Kellner

Obbels

Sienaert

2019

Acta Psychiatr Scand

121

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When to consider electroconvulsive therapy (ECT) Kellner CH, Obbels J, Sienaert P. When to consider electroconvulsive therapy (ECT).Objective: To familiarize the reader with the role of electroconvulsive therapy (ECT) in current psychiatric medicine. Method: We review clinical indications for ECT, patient selection, contemporary ECT practice, maintenance treatment and ECT in major treatment guidelines. Results: ECT is underutilized largely due to persisting stigma and lack of knowledge about modern ECT technique. Conclusion: ECT remains a vital treatment for patients with severe mood disorders, psychotic illness and catatonia. Clinical recommendations for ECT• ECT should be prescribed earlier in the course of a severe depressive episode, not necessarily withheld until after numerous medication trials • ECT may be considered a first-line (primary) treatment for certain urgently ill patients, including those who are very suicidal, psychotic, or physically debilitated from depression Diagnostic indications for ECT • In many Western countries, severe and treatment-resistant depression is the main indication for ECT • Schizophrenia is the number one indication for ECT worldwide, but is little used for this indication in Western countries • ECT is an effective treatment for treatment-resistant mania • Delirious mania is an urgent indication for ECT • ECT is effective for treatment-resistant schizophrenia, including clozapine-resistant illness • Catatonia is very responsive to ECT • Both the motor and behavioural symptoms of Parkinson's disease respond to ECT Predictors of ECT response • Older age, psychotic symptoms, and shorter episode duration are predictors of better ECT response • Melancholic features and greater baseline depressive symptom severity are likely associated with better ECT response 304 ECT technique • Bilateral, bifrontal, and right unilateral electrode placement are all effective ECT techniques • Less urgently ill patients are often treated initially with right unilateral electrode placement • Brief and ultrabrief pulse width stimuli, now commonly used, are associated with a more benign cognitive effect profile • There is no a priori fixed number of ECT in an acute course: patients should continue treatment with ECT until they remit or a plateau has been reached, or tolerability issues require interruption of the course • Tapering of acute courses of ECT should be considered for most patients (e.g., approximately weekly treatments for several weeks past remission) • Continuation/Maintenance (C/M) ECT should be considered for patients with a history of severe, recurrent episodes who have failed to remain well on medications Additional comments • ECT is underutilized because of stigma, lack of knowledge about it, and bureaucratic restrictions • ECT is among the safest procedures performed under general anesthesia • Cognitive adverse effects are markedly decreased with modern ECT techniques, largely transient, and should not deter seriously ill patients from considering ECT.

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Section: Pregnancy and Postpartummentioning

confidence: 99%

When to consider electroconvulsive therapy (ECT)

Kellner

Obbels

Sienaert

2019

Acta Psychiatr Scand

121

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“…As a result of the overall prevalence of female depressed individuals, the number of female depressed patients who participated in ECT was greater than male (Liang et al, 2017;Slade et al, 2017;McCall et al, 2018). Interestingly, female ECT recipients may respond better in the postpartum period (Rundgren et al, 2018). In addition, estradiol withdrawal could be partially to blame, since estradiol has a protective role against depression in females (Schmidt et al, 2015) but boosts depression in young men (Stanikova et al, 2018).…”

Section: Prediction Of Response and Relapse To Ect Bioinformaticsmentioning

confidence: 99%

“…In short, in the elderly (Husain et al, 2004), psychotic symptom comorbidities (Husain et al, 2004), postpartum depression (Rundgren et al, 2018), shorter episode duration and more severe depressive symptoms (van Diermen et al, 2018), early depression alleviation (Birkenhager et al, 2019), lower NAA levels in the dACC at baseline (Njau et al, 2017), low genetic risk load (Foo et al, 2019), genetic or epigenetic modifications (Huuhka et al, 2007;Kleimann et al, 2015;Lin et al, 2015), and high baseline serum IL-6 levels (Kruse et al, 2018) and a serum MM-9 profile (Shibasaki et al, 2018) were more likely to benefit ECT recipients. Moreover, the subfield index of hippocampus and neural network plasticity (Abbott et al, 2014;Ota et al, 2015;van Waarde et al, 2015;Redlich et al, 2016;Cao et al, 2018;Nuninga et al, 2019) may provide precise evidence to predict the outcome.…”

Section: Prediction Of Response and Relapse To Ect Bioinformaticsmentioning

confidence: 99%

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

Yao

Sun

et al. 2020

Front. Psychol.

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Depression is one of the most common disorders causing mortality around the world. Although electroconvulsive therapy (ECT) is, along with antidepressants and psychotherapy, one of the three major treatments of depression, it is still considered as the last resort for depressed patients. This situation is partially due to limited studies and uncertainty regarding its mechanism. However, decades of increased research have focused on the effects of ECT on depression and its potential mechanism. Furthermore, these investigations may suggest that ECT should be a first-line therapy for depression due to its profound effects in relieving desperation in certain situations. Here, we outline recent clinical and preclinical studies and summarize the advantages and disadvantages of ECT. Thus, this review may provide some hints for clinical application.

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“…When suicidal ideas and intentions or severe psychotic symptomatology are present, along with a weak response to pharmacotherapy, it is necessary to consider hospitalization and the application of electroconvulsive therapy (32,33).…”

Section: Antidepressantsmentioning

confidence: 99%

“…ECT is particularly worth considering in case there is a need for a fast resolution of symptoms and in resistant forms when there is lack of response to monopharmacotherapy. In these cases, application of ECT is advised before or even instead of a combination of medications (32,33).…”

Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

Therapy of peripartum mental disorders

Stanković¹,

Stojanov²,

Antonijević³

2019

Acta fac medic Naissensis

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S U M M A R YDuring the peripartum period, women are at a greater risk of developing a mental disorder or experiencing an exacerbation of the pre-existing mental disorders. Therapeutic interventions are based primarily on psychotherapy, but if the symptoms are severe and pose a risk to the mother and the child, then the use of drugs, hospitalization or electroconvulsive therapy is considered. Cognitive-behavioral psychotherapy is the first line of treatment in postpartum blues and postpartum depression, panic disorder, generalized anxiety disorder, and mild to moderate obsessive-compulsive disorder. More recent conceptions regarding the use of drugs during the postpartum period indicate that medications should be prescribed if the risk of using them is lower than the risk of complications caused by the symptoms of mental disorders. Nortriptyline or desipramine are recommended from the group of tricyclic antidepressants, but newer generation antidepressants are shown to be safer during pregnancy. Fluvoxamine, paroxetine and sertraline can be used in postpartum period during breastfeeding, while fluoxetine and citalopram should be avoided. The use of first-generation antipsychotics haloperidol and trifluoperazine is recommended in the antepartum period, during which some of second-generation antipsychotics such as quetiapine, olanzapine, risperidone and aripiprazole can also be used. Clozapine should be avoided during breast-feeding. The use of mood stabilizers during pregnancy requires a thorough knowledge of the recommendations, and it is not advised to use them during the postpartum if the patient is breastfeeding. From the group of benzodiazepines, it is recommended to uselorazepam. Every form of therapeutic approach has proven to be more effective in the presence of emotional support from partners and other family members.

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Improvement of postpartum depression and psychosis after electroconvulsive therapy: A population-based study with a matched comparison group

Cited by 46 publications

References 39 publications

When to consider electroconvulsive therapy (ECT)

When to consider electroconvulsive therapy (ECT)

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

Therapy of peripartum mental disorders

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