Usefulness of Treatment Reports for Electroconvulsive Therapy.

Usefulness of Treatment Reports for Electroconvulsive Therapy.

J ECT. 2013 Apr 19;
Bennett DM, Fernie G, Currie J, Reid IC

OBJECTIVES: Electroconvulsive therapy (ECT) is often given by a specialist ECT team on behalf of a patient’s treating psychiatrist. A key aspect of this interface is the communication between these care teams. This study describes the introduction of an ECT treatment report at the Royal Cornhill Hospital in Aberdeen. The aim of the current study was to evaluate whether these reports were useful to psychiatrist. METHODS: The report was designed to provide feedback to the treating psychiatrists on a range cognitive (Mini Mental State Examination, spatial recognition memory on the Cambridge Automated Neuropsychological Testing Battery, Squire Subjective Memory Scale, and Prospective And Retrospective Memory Questionnaire) and mood scores (Montgomery Åsberg Depression Rating Scale) routinely collected by the ECT team. The reports contain the patient’s score and the mean of all patients treated in the service. A questionnaire was sent to all treating psychiatrists to evaluate the usefulness of the reports. RESULTS: A 76% response rate was obtained. The reports were well received by treating teams, among whom 78.9% thought they were necessary, 74% thought they were easy to understand, and 79% thought the report was informative. A minority 47.4% thought the report influenced clinical practice, and only 31.3% showed the report to patients. CONCLUSIONS: From the results of our evaluation, the provision of an “ECT Treatment Report” providing a summary of the routinely collected mood and cognitive rating data was useful for psychiatrists prescribing ECT. It is thus likely that such a report would be useful in other ECT services. HubMed – depression

The Use of Propofol to Prevent Fetal Deceleration During Electroconvulsive Therapy Treatment.

J ECT. 2013 Apr 19;
De Asis SJ, Helgeson L, Ostroff R

Electroconvulsive therapy has been demonstrated to be relatively safe during pregnancy for both the mother and the fetus. One risk to the fetus is cardiac deceleration during the grand mal seizure. We present a case of a young woman in her second trimester of pregnancy with bipolar depression. She had a prolonged seizure on her second electroconvulsive therapy treatment, which led to transient fetal bradycardia that self-corrected as preparations were underway for an emergency cesarean delivery. A change of her anesthetic agent from methohexital to propofol attenuated the seizure duration resulting in the elimination of further events of fetal cardiac deceleration and a successful outcome for both mother and fetus. HubMed – depression

Mind-Body Practices for Posttraumatic Stress Disorder.

J Investig Med. 2013 Apr 19;
Kim SH, Schneider SM, Kravitz L, Mermier C, Burge MR

BACKGROUND: Mind-body practices are increasingly used to provide stress reduction for posttraumatic stress disorder (PTSD). Mind-body practice encompasses activities with the intent to use the mind to impact physical functioning and improve health. METHODS: This is a literature review using PubMed, PsycINFO, and Published International Literature on Traumatic Stress to identify the effects of mind-body intervention modalities, such as yoga, tai chi, qigong, mindfulness-based stress reduction, meditation, and deep breathing, as interventions for PTSD. RESULTS: The literature search identified 92 articles, only 16 of which were suitable for inclusion in this review. We reviewed only original, full text articles that met the inclusion criteria. Most of the studies have small sample size, but findings from the 16 publications reviewed here suggest that mind-body practices are associated with positive impacts on PTSD symptoms. Mind-body practices incorporate numerous therapeutic effects on stress responses, including reductions in anxiety, depression, and anger, and increases in pain tolerance, self-esteem, energy levels, ability to relax, and ability to cope with stressful situations. In general, mind-body practices were found to be a viable intervention to improve the constellation of PTSD symptoms such as intrusive memories, avoidance, and increased emotional arousal. CONCLUSIONS: Mind-body practices are increasingly used in the treatment of PTSD and are associated with positive impacts on stress-induced illnesses such as depression and PTSD in most existing studies. Knowledge about the diverse modalities of mind-body practices may provide clinicians and patients with the opportunity to explore an individualized and effective treatment plan enhanced by mind-body interventions as part of ongoing self-care. HubMed – depression

Risk for Adverse Events and Discontinuation Due To Adverse Events of Ziprasidone Monotherapy Relative to Placebo in the Acute Treatment of Bipolar Depression, Mania, and Schizophrenia.

J Clin Psychopharmacol. 2013 Apr 19;
Gao K, Pappadopulos E, Karayal ON, Kolluri S, Calabrese JR

OBJECTIVE: This study aimed to examine the risk difference (RD) in the discontinuation due to adverse events, akathisia, overall extrapyramidal symptoms (EPS), reported-somnolence, and 7% or greater weight gain between ziprasidone monotherapy and placebo in the acute treatment of bipolar depression (BPD), bipolar mania (BPM), and schizophrenia. METHODS: Pooled data from 9 randomized, double-blind, placebo-controlled, acute studies of ziprasidone in BPD, BPM, and schizophrenia were used. The number needed to treat to harm (NNTH) of ziprasidone relative to placebo was estimated when an RD was statistically significant. RESULTS: The RD in discontinuation due to adverse events or 7% or greater weight gain between ziprasidone and placebo was not significant in all 3 psychiatric conditions. The risk for akathisia with ziprasidone was significantly higher in BPD with an RD of 2.3% (NNTH = 44) and in BPM with an RD of 8.4% (NNTH = 12). Risk for overall EPS with ziprasidone was significantly higher in BPM with an RD of 8.7% (NNTH = 12) and schizophrenia with an RD of 3.3% (NNTH = 30). Risk of reported-somnolence with ziprasidone was also significantly higher in BPD with an RD of 11.8% (NNTH = 8), BPM with an RD of 14.3% (NNTH = 7), and schizophrenia with an RD of 7% (NNTH = 14). Dose-dependent increase in the risk for reported somnolence with ziprasidone was observed in BPD and schizophrenia. CONCLUSIONS: Ziprasidone was associated with significant differential adverse effects relative to placebo in BPM, BPD, and schizophrenia with no significant difference in weight gain in all 3 groups. Self-reported somnolence was increased across the 3 conditions. Subjects with BPM were more vulnerable to EPS than those with BPD or schizophrenia. HubMed – depression

Association of Brain Serotonin Transporter Availability and Brain-Derived Neurotrophic Factor in Models of Serotonin Transporter Genotypes in Healthy Subjects.

J Clin Psychopharmacol. 2013 Apr 19;
Chou YH, Chen CK, Wang SJ, Tsai SJ, Lirng JF, Liou YJ, Lin CL, Yang KC, Lin MW, Lo WC, Liao MH, Chen CC

The S-allele of functional polymorphisms of the serotonin transporter (SERT) gene has been demonstrated to have lower transcriptional activity compared with the L-allele, which shows low expression of SERT in the brain. However, this finding cannot be consistently replicated in vivo. The aim of this study was to determine the availability of SERT based on SERT genotype. We also examined the relationship between brain-derived neurotrophic factor (BDNF) and the availability of SERT. Sixty-two healthy subjects were recruited. Each subject underwent single-photon emission computed tomography with I-ADAM (I-labeled 2-([2-({dimethylamino}methyl)phenyl]thio)-5-iodophenylamine) for imaging SERT in the brain. The specific uptake ratio was measured, and venous blood was drawn when the subject underwent single-photon emission computed tomography to evaluate BDNF levels and SERT genotype. All subjects expressed SERT genotypes that were consistent with a biallelic model, and 26 subjects had SERT genotypes that were consistent with a triallelic model. No differences in specific uptake ratio were detected in the midbrain, putamen, caudate, and thalamus based on the SERT genotype using the biallelic and triallelic models. Interestingly, The Pearson correlation coefficient revealed a positive correlation between BDNF and SERT availability. In particular, this relationship was observed in homozygous S-allele expression and a genotype with low functional expression (SaSa/SaLg) in the biallelic and triallelic models of SERT genotypes, respectively. This finding might explain why the SS genotype of SERT did not increase the risk of major depressive disorder in Asian populations and implicate an important role of BDNF in the patients, who has the SS genotype of the SERT gene. HubMed – depression