Posts

Difficult-to-treat-depression: ECT Data From a German Cohort

Image
 Out on PubMed, from authors in Germany, is this study: Risk Phenotypes, Comorbidities, Pharmacotherapy, and Electroconvulsive Therapy ( ECT ) in a Cohort with Difficult-to-Treat Depression in Comparison to an Unmedicated Control Group. Maier HB, Borchert A, Neyazi A, Moschny N, Schülke R, Bundies GL, Folsche T, Gaspert A, Seifert J, Bleich S, Scherf-Clavel M, Unterecker S, Deckert J, Frieling H, Weber H. Pharmacopsychiatry. 2024 May 2. doi: 10.1055/a-2292-1438. Online ahead of print. PMID:  38698605   The abstract is copied below: Background: Approximately 15-25% of depressed patients suffer from difficult-to-treat depression (DTD). Patients with DTD require a thorough examination to avoid the oversight of treatable (psychiatric/somatic) comorbidities or (pseudo-)resistance to antidepressant drugs (ADs). Polymorphisms of the cytochrome P450 (CYP) enzymes 2D6 and 2C19, which play a major role in the metabolism of ADs, may contribute to resistance to ADs. Patients with DTD might benef
Post a Comment
Read more

Washington Post Story About Man With Bipolar Disorder: ECT Mentioned in Not-So-Good Way

Image
This story appeared in the Washington Post on April 27,2024. The link to the article is here: https://www.washingtonpost.com/nation/interactive/2024/marjorie-taylor-greene-threats/ And from the text: So here is a long article about an incident in the life of a man with severe bipolar disorder; ECT is only a peripheral part of it, but that is what we are here to focus on. There are three issues in my mind. The first is his description of what is certainly an anesthesia awareness event. The suggestion that it was a panic attack is true as far as it goes, but it was caused by the awareness experience. Awareness events related to succinylcholine can occur at either induction or emergence. Unfortunately, even when they occur at induction, the subsequent seizure often does not erase them. The ECT care team should be aware themselves of this potential complication and try to avoid it at all costs. It is terrifying to the patient and, as noted here, may cause them to refuse further treatments.
Post a Comment
Read more

MST vs ECT: LTE in JAMA Psychiatry, The Response

Image
Out on PubMed, is this responsive LTE: Magnetic Seizure Therapy vs  Electroconvulsive  Therapy for Major Depressive Episode-Reply. Deng ZD, Weiner RD, Lisanby SH. JAMA Psychiatry. 2024 Apr 24. doi: 10.1001/jamapsychiatry.2024.0695. Online ahead of print. PMID:  38656323 The letter is here . And here: Here is the response from Deng et al. to the prior letter from McCall et al. I find these rationales for the surprising weakness of the type of  ECT used, and the weakness of the MST, to be less than convincing. MST may develop into a promising treatment with efficacy that rivals ECT, but the current data show it is not there yet. There will be more on this topic soon...
Post a Comment
Read more

MST vs ECT: LTE in JAMA Psychiatry

Image
 Out on PubMed, from American authors, is this LTE: Magnetic Seizure Therapy vs  Electroconvulsive  Therapy for Major Depressive Episode. McCall WV, George MS, Sackeim HA. JAMA Psychiatry. 2024 Apr 24. doi: 10.1001/jamapsychiatry.2024.0692. Online ahead of print. PMID:  38656342   The LTE is here. And here: Here is an LTE from Vaughn McCall and colleagues critiquing the recent Deng et al. study comparing MST to ECT in JAMA Psychiatry . The points made are well taken. Both the Deng et al. and Anand et al. studies were designed with a relatively weak form of ECT. This, of course, has the effect of making the experimental comparator look stronger. ECT endures, and still has a prominent position in the treatment of urgently ill mood and psychotic disorders patients, despite ongoing attempts to downplay its efficacy and safety. Stay tuned to the blog for the response from Deng et al....
Post a Comment
Read more

Max Fink On Flurothyl: New Essay in JECT

Image
 In press in JECT, is this essay by Dr. Max Fink: The essay is here . And here: I am pleased to present Professor Max Fink's essay on resurrecting flurothyl as a method to induce seizures instead of electricity. His arguments are cogent. It would be great to hear from blog readers what they think about the viability of flurothyl as another type of convulsive therapy in contemporary psychiatry. Kudos to Max for his ongoing amazing contributions to the ECT/convulsive therapy literature!
Post a Comment
Read more

Effects of Isoflurane Anesthesia in ECS: Findings in "Data In Brief"

Image
Out on PubMed, from researchers in Arizona and Canada, is this paper: Data on electroconvulsive seizure in mice, effects of anesthesia on immediate early gene expression. Ozols AB, Meyers KT, Damphousse CC, Campbell JM, Khoshaba R, Wallace SG, Hu C, Marrone DF, Gallitano AL. Data Brief. 2024 Mar 27;54:110365. doi: 10.1016/j.dib.2024.110365. eCollection 2024 Jun. PMID:  38646190   The abstract is copied below: Although electroconvulsive therapy (ECT) is one of the most effective treatments for severe mood and psychotic disorders, the mechanisms underlying its therapeutic effects remain unknown. Electroconvulsive stimulation (ECS), the animal model for ECT, can be used to investigate the potential therapeutic mechanisms of ECT in rodents . ECS produces numerous effects in the brain, such as increasing levels of growth factors, inducing dendritic sprouting, and stimulating neurogenesis. It also induces high-level expression of immediate early genes (IEGs) that have been implicated in the
Post a Comment
Read more

Retrospective Study on Suicide/Suicidal Ideation During Depression: Treatment Data (Including ECT) From China

Image
 Out on PubMed, from researchers in China, is this study: Real-world evidence from a retrospective study on suicide during depression: clinical characteristics, treatment patterns and disease burden. Wang H, Lyu N, Huang J, Fu B, Shang L, Yang F, Zhao Q, Wang G. BMC Psychiatry. 2024 Apr 19;24(1):300. doi: 10.1186/s12888-024-05726-y. PMID:  38641767 The abstract is copied below: Background: Suicide stands as both a primary symptom and the direst outcome of major depressive disorder (MDD). The scarcity of effective treatment strategies makes managing MDD patients with suicide especially challenging. Hence, it is crucial to investigate disease characteristics and efficacious therapeutic strategies for these patients, drawing insights from disease databases and real-world data. Methods: In this retrospective study, MDD patients hospitalized between January 2013 and December 2020 were investigated using Electronic Health Records (EHR) data from Beijing Anding Hospital. The study enrolled 41
Post a Comment
Read more