Resolution of Acute Suicidality After a Single Right Unilateral Electroconvulsive Therapy

Fligelman, Boris; Pham, Tony V; Bryson, Ethan O.; Majeske, Matthew; Kellner, Charles H.

doi:10.1097/yct.0000000000000258

Cited by 9 publications

(10 citation statements)

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“…Notably, pronounced postictal EEG slowing has been associated with rapid antidepressant responses (Folkerts, 1996) and clinical improvement after ECT (Nobler et al, 1993;Suppes et al, 1996). As already noted, though a single seizure is usually insufficient to produce marked symptomatic relief in depression, some patients have responded already to a single ECT (Rich, 1984;Fligelman et al, 2016). In further support of the idea of the homeostatic emergence of waking SWA in response to neural activity, a clinical study using cortical intermittent theta burst stimulation found increases in waking delta frequency power following the stimulation .…”

Section: Sleep and Rapid Antidepressant Effectsmentioning

confidence: 98%

“…Electroconvulsive therapy (ECT) remains as one of the most effective interventions for treatment-resistant depression. Though series of consecutive treatments are typically required for therapeutic effects of ECT, some studies have shown antidepressant effects already after the first treatment episodes (Rich, 1984;Fligelman et al, 2016). The alternating current induced by ECT essentially forces activity into groups of cortical neurons (Fink, 2014).…”

Section: Examining Rapid Antidepressant Effects Through Encodingmentioning

confidence: 99%

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Encoding, Consolidation, and Renormalization in Depression: Synaptic Homeostasis, Plasticity, and Sleep Integrate Rapid Antidepressant Effects

Rantamäki

Kohtala

2020

Pharmacol Rev

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Brain and Mind Doctoral Program (S.K.), the Orion Research Foundation (S.K.), and the Emil Aaltonen foundation (S.K.). T.R. and S.K. are listed as coinventors on a patent application, wherein new tools enabling the development of rapid-acting antidepressants and the efficacy monitors thereof are disclosed based on the basic principles of ENCORE-D. T.R. and S.K. have assigned their patent rights to the University of Helsinki but will share a percentage of any royalties that may be received by the University of Helsinki.

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Section: Sleep and Rapid Antidepressant Effectsmentioning

confidence: 98%

Section: Examining Rapid Antidepressant Effects Through Encodingmentioning

confidence: 99%

Encoding, Consolidation, and Renormalization in Depression: Synaptic Homeostasis, Plasticity, and Sleep Integrate Rapid Antidepressant Effects

Rantamäki

Kohtala

2020

Pharmacol Rev

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“…We could not critically evaluate those articles or challenge the reported data. Moreover, as mentioned earlier, we had to exclude six studies whose Sackett Scale was equal or inferior to 4 (Brunoni, Júnior, et al, 2013; Brunoni, Valiengo, et al, 2013; Fligelman et al, 2016; Gambill & McLean, 1983; Kobeissi et al., 2011; Pan et al., 2018; Rapinesi et al., 2014;). These case series or uncontrolled pre–post‐tests should also be recognized because of their values.…”

Section: Discussionmentioning

confidence: 99%

Can seizure therapies and noninvasive brain stimulations prevent suicidality? A systematic review

et al. 2021

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Background Suicide is a major public health issue and the majority of those who attempt suicide suffer from mental disorders. Beyond psychopharmacotherapy, seizure therapies and noninvasive brain stimulation interventions have been used to treat such patients. However, the effect of these nonpharmacological treatments on the suicidal ideation and incidence of suicidality remains unclear. Here, we aimed to provide an update on the effects of seizure therapies and noninvasive brain stimulation on suicidality. Methods We conducted a systematic review of the literature in the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Elsevier ScienceDirect, and Wiley Online Library databases using the MeSH terms “Electroconvulsive Therapy”, “Magnetic Seizure Stimulation”, “repetitive Transcranial Magnetic Stimulation”, “transcranial Direct Current Stimulation”, “Cranial Electrostimulation” and “suicide”. We included studies using seizure therapies and noninvasive brain stimulation as a main intervention that evaluated suicidality, regardless of diagnosis. Results Among 1,019 records screened, 26 studies met the inclusion criteria using either electroconvulsive therapy (n = 14), magnetic seizure therapy (n = 2), repetitive transcranial magnetic stimulation (n = 9), or transcranial direct current stimulation (n = 1). We observed that studies reported significant results, suggesting these techniques can be effective on the suicidal dimension of mental health pathologies, but a general statement regarding their efficacy is premature due to limitations. Conclusions Future enquiry is necessary to address methodological limitations and evaluate the long‐term efficacy of these methods both alone and in combination with pharmacotherapy and/or psychotherapy.

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“…The therapeutic effects of ECT become evident faster than those of conventional antidepressants (Segman et al 1995), yet reduction of symptoms after a single ECT treatment is only seldom reported (Rich 1984;Thomas and Kellner 2003;Fligelman et al 2016). An electric current leading into a short epileptiform electroencephalogram (EEG) activity is delivered during ECT under light anesthesia but how this Bseizurel eads into a remedy remains a mystery.…”

Section: Differential Effects Of Electroconvulsive Shock and Anesthesmentioning

confidence: 99%

TrkB neurotrophin receptor at the core of antidepressant effects, but how?

Rantamäki

2019

Cell Tissue Res

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The role of brain-derived neurotrophic factor (BDNF) and its receptor TrkB has been studied in the context of mood disorders and their treatments for a couple of decades. Pharmacologically diverse antidepressant drugs increase the synthesis of BDNF in the cortex (and some subcortical structures) and this effect accounts for their ability to facilitate neurotrophic processes eventually leading into heightened plasticity within the cortex. Induction of BDNF-TrkB signaling has also been associated with the mechanism of action of ketamine and more recently with some other anesthetics, even with ones not thought to possess antidepressant potential. Notably, both ketamine and conventional antidepressants activate TrkB receptor and its downstream signaling rapidly within the same time scale in the brain while electroconvulsive therapy (ECT), among the most potent inducers of BDNF, has not been unequivocally shown to produce such acute effects on TrkB. The ability of antidepressants to regulate TrkB signaling is developmentally regulated and requires an intact central nervous system. The purpose of this review is to highlight and discuss some of these peculiarities associated with the effects of ketamine and classical antidepressants and BDNF on TrkB signaling.

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Resolution of Acute Suicidality After a Single Right Unilateral Electroconvulsive Therapy

Cited by 9 publications

References 0 publications

Encoding, Consolidation, and Renormalization in Depression: Synaptic Homeostasis, Plasticity, and Sleep Integrate Rapid Antidepressant Effects

Encoding, Consolidation, and Renormalization in Depression: Synaptic Homeostasis, Plasticity, and Sleep Integrate Rapid Antidepressant Effects

Can seizure therapies and noninvasive brain stimulations prevent suicidality? A systematic review

TrkB neurotrophin receptor at the core of antidepressant effects, but how?

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