Electroconvulsive therapy--efficacy and side-effects. 2010

Kjell Martin Moksnes, and Stein Opjordsmoen Ilner
Department of Geriatric Psychiatry, Mental Health and Dependence Clinic, Oslo University Hospital, Slottsberget 35, 1385 Asker, Norway. kjellmartin.moksnes@ulleval.no

BACKGROUND Efficacy of electroconvulsive therapy (ECT) and duration of associated side effects is uncertain. We wanted to study indications, efficacy, time to response and side effects. METHODS ECT-protocols and medical records (from the period 1960-95) in three psychiatric wards of Dikemark Mental Hospital, Norway were systematically assessed. RESULTS 141 persons underwent 241 ECT series comprising 1960 treatment sessions. Major depressive disorder was the main diagnosis in most patients 124 [88 %]. Before ECT, 129 (91 %) patients had been treated with at least one antidepressant, 107 (76 %) with at least two and 67 (48 %) with two different classes of antidepressants without sufficient clinical recovery from the incident. 31 (22 %) had received lithium before ECT. Within four weeks after the first ECT, 120 (85 %) patients had recovered. 61 of these achieved remission and were discharged within four weeks. After the first ECT series, 92 patients showed signs of improvement. 71 (77 %) had signs of improvement within 6 days. Side effects were noted after 123 of totally 241 series (51 %). Five patients experienced serious complications. Interpretation. The immediate effect of ECT was good and signs of recovery were observed in most patients during the first week. Depressed psychotic patients and the elderly seemed to respond best. Considering these patients' serious and long-lasting disorders ECT was fairly safe and well tolerated.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003865 Depressive Disorder, Major Disorder in which five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include: depressed mood most of the day, nearly every daily; markedly diminished interest or pleasure in activities most of the day, nearly every day; significant weight loss when not dieting or weight gain; Insomnia or hypersomnia nearly every day; psychomotor agitation or retardation nearly every day; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness, nearly every day; or recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. (DSM-5) Depression, Involutional,Major Depressive Disorder,Melancholia, Involutional,Paraphrenia, Involutional,Psychosis, Involutional,Depressive Disorders, Major,Involutional Depression,Involutional Melancholia,Involutional Paraphrenia,Involutional Paraphrenias,Involutional Psychoses,Involutional Psychosis,Major Depressive Disorders,Paraphrenias, Involutional,Psychoses, Involutional
D004565 Electroconvulsive Therapy Electrically induced CONVULSIONS primarily used in the treatment of severe AFFECTIVE DISORDERS and SCHIZOPHRENIA. Convulsive Therapy, Electric,ECT (Psychotherapy),Electroshock Therapy,Shock Therapy, Electric,Convulsive Therapies, Electric,Electric Convulsive Therapies,Electric Convulsive Therapy,Electric Shock Therapies,Electric Shock Therapy,Electroconvulsive Therapies,Electroshock Therapies,Shock Therapies, Electric,Therapies, Electric Convulsive,Therapies, Electric Shock,Therapies, Electroconvulsive,Therapies, Electroshock,Therapy, Electric Convulsive,Therapy, Electric Shock,Therapy, Electroconvulsive,Therapy, Electroshock
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017063 Outcome Assessment, Health Care Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). Assessment, Outcome,Outcome Assessment,Outcome Assessment (Health Care),Outcomes Research,Assessment, Outcomes,Outcome Measures,Outcome Studies,Outcomes Assessment,Assessment, Outcome (Health Care),Assessments, Outcome,Assessments, Outcome (Health Care),Assessments, Outcomes,Measure, Outcome,Measures, Outcome,Outcome Assessments,Outcome Assessments (Health Care),Outcome Measure,Outcome Study,Outcomes Assessments,Research, Outcomes,Studies, Outcome,Study, Outcome

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