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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...
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Updated: Jan 3, 2026

Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Factors Associated With Delirium Following Electroconvulsive Therapy: A Systematic Review.

Takashi Tsujii1,2, Takahito Uchida1, Takefumi Suzuki3

  • 1From the Department of Neuropsychiatry, Keio University School of Medicine, Tokyo.

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|November 26, 2019
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Post-electroconvulsive therapy (ECT) delirium is linked to factors like dementia and bitemporal placement. Dexmedetomidine and ultrabrief pulse ECT may help prevent delirium.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Medicine

Background:

  • Delirium following electroconvulsive therapy (ECT) presents a significant clinical challenge.
  • Previous research has not systematically reviewed factors associated with post-ECT delirium.

Purpose of the Study:

  • To systematically synthesize existing evidence on risk factors for delirium after electroconvulsive therapy (ECT).

Main Methods:

  • A systematic literature search was conducted using PubMed to identify original investigations reporting risk factors for post-ECT delirium.

Main Results:

  • Catatonic features, cerebrovascular disease, Parkinson disease, and dementia were associated with increased post-ECT delirium risk.
  • Bitemporal stimulation, high stimulus intensity, and longer seizure duration increased delirium incidence.
  • Dexmedetomidine showed a decreased incidence of postictal delirium, while ultrabrief pulse ECT reduced reorientation time.

Conclusions:

  • Factors increasing post-ECT delirium risk include catatonic features, neurological conditions, and specific ECT parameters.
  • Dexmedetomidine and ultrabrief pulse ECT show promise in preventing post-ECT delirium.