Rate of continuing acute course treatment using right unilateral ultrabrief pulse electroconvulsive therapy at a large a
- PDF / 625,519 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 143 Views
ORIGINAL PAPER
Rate of continuing acute course treatment using right unilateral ultrabrief pulse electroconvulsive therapy at a large academic medical center James Luccarelli1,2,4 · Thomas H. McCoy Jr1,4 · Alec P. Shannon1 · Brent P. Forester3,4 · Stephen J. Seiner2,4 · Michael E. Henry1,4 Received: 30 June 2020 / Accepted: 14 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Right unilateral ultrabrief pulse (RUL-UBP) ECT has emerged as a promising technique for minimizing cognitive side effects of ECT while retaining clinical efficacy, but it is unknown how often patients will require alternative treatment parameters and at what point in the treatment course this occurs. To better define this problem, this study analyzes continuation in RUL-UBP ECT in a retrospective cohort of patients beginning acute course treatment. A single-center retrospective chart review was conducted of adult patients receiving a first lifetime course of ECT from 2010 to 2017 starting with RUL-UBP treatment parameters. 1793 patients met study criteria. Patients received a mean of 10.0 ± 3.2 ECT treatments, of which a mean of 8.4 ± 3.4 were RUL-UBP treatments; proportion using RUL-UBP through 12 treatments was 57.8%. In total, 65.6% of patients were treated with RUL-UPB ECT exclusively. Mean dose increased from 7.6 × seizure threshold at the second RUL-UBP treatment to 14.3 × seizure threshold at the twelfth RUL-UBP treatment. Rates of continuation in RUL-UBP ECT did not differ based on age or on primary diagnosis of major depression vs. bipolar disorder. Among patients beginning acute-course treatment using RUL-UPB ECT, two thirds were treated with these parameters exclusively. Among patients who received twelve RUL-UBP treatments, mean final dose was 14.3 × seizure threshold. Further studies regarding optimal dosing of RUL-UBP ECT are indicated. Keywords Electroconvulsive therapy · Cohort studies · Survival analysis · Ultrabrief pulse
Introduction Electroconvulsive therapy (ECT) is an effective treatment for depressive disorders [1], and after 80 years of use remains a critical tool for psychiatric treatment [2]. A key focus of Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00406-020-01202-2) contains supplementary material, which is available to authorized users. * James Luccarelli [email protected] 1
Department of Psychiatry, Massachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA 02114, USA
2
Department of Psychiatry, McLean Hospital, Belmont, MA, USA
3
Division of Geriatric Psychiatry, McLean Hospital, Belmont, USA
4
Harvard Medical School, Boston, MA, USA
modern ECT research is maintaining therapeutic efficacy while minimizing cognitive side effects. This includes the use of right unilateral (RUL) electrode positioning and ultrabrief pulse (UBP) stimulation parameters, in which the duration of the electrical stimulus is reduced to
Data Loading...
