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Related Concept Videos

Electroconvulsive Therapy01:30

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...
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Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
04:51

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy

Published on: April 11, 2019

Change in seizure threshold during electroconvulsive therapy.

Max Fink1, Georgios Petrides, Charles Kellner

  • 1Long Island Jewish-Hillside Hospital, Glen Oaks, NY, USA. mafink@attglobal.net

The Journal of ECT
|June 27, 2008
PubMed
Summary
This summary is machine-generated.

The seizure threshold (ST) in electroconvulsive therapy (ECT) did not consistently increase with remission in unipolar depressed patients. This study examined ST changes after successful ECT treatment.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Medicine

Background:

  • The seizure threshold (ST) quantifies the minimum electrical energy for inducing a grand mal seizure.
  • Dose titration of ST is a proposed method to optimize electroconvulsive therapy (ECT) stimulus dosing.
  • Understanding ST changes during remission is crucial for refining ECT protocols.

Purpose of the Study:

  • To investigate the relationship between seizure threshold and remission in unipolar depression patients undergoing ECT.
  • To determine if the seizure threshold consistently changes as patients achieve remission from depression.

Main Methods:

  • A cohort of unipolar depressed patients receiving continuation treatment after successful ECT was studied.
  • Seizure threshold (ST) was measured at the initial ECT treatment and one week post-remission.
  • Bilateral electrode placement was used, with stimulation at 150% above the measured ST.

Main Results:

  • In 80 subjects, the seizure threshold remained stable in 70% of patients at remission.
  • A notable increase in ST was observed in 21% of patients.
  • A decrease in ST was recorded in 9% of the study participants.

Conclusions:

  • The seizure threshold does not conclusively rise with remission in patients receiving bilateral ECT.
  • Findings suggest variability in ST response to remission, impacting ECT dose optimization strategies.