Journal of affective disorders
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Certain pharmacological agents administered during electroconvulsive therapy may have the potential to prevent persistent retrograde amnesia induced during electroconvulsive therapy. This review examines mechanisms for electroconvulsive therapy-induced retrograde amnesia, and evaluates the suitability of the anaesthetic ketamine for preventing this amnestic outcome. ⋯ A clinical trial is warranted to determine if ketamine anaesthesia during electroconvulsive therapy can lessen persistent retrograde amnesia and improve therapeutic response. Electroconvulsive therapy with ketamine anaesthesia may provide effective antidepressant action with minimal side effects.
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Patients with major depressive disorder (MDD) may display elevated plasma levels of pro-inflammatory substances. Although the underlying mechanisms are unknown, inflammation has been proposed to play a direct role in the generation of depressive symptoms. Skeletal muscle is a potent producer of cytokines, and physical exercise has been suggested to alleviate symptoms of depression. In this study we therefore addressed the question of whether MDD patients display altered levels of pro-, anti-inflammatory and regulatory factors in the blood in response to acute exercise. ⋯ Exercise induces changes in the blood levels of cytokines in unmedicated MDD patients. Whether these changes affect symptoms of depression should be evaluated in long-term studies of the anti-depressive effects of exercise.
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The literature is unclear regarding the relationship between hospital outcome (i.e., symptom improvement during a hospital admission) and readmission, questioning the validity of readmission as an indicator of the quality of the previous hospitalization. Thus, the present aim was to examine if hospital outcome is a predictor of readmission and identify the factors that may mask any effects. ⋯ These findings support that readmission may be a useful indicator of the quality of the previous hospitalization.
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The addition of small amounts of lignocaine (50 mg) to propofol (200 mg) has been previously shown to reduce pain in injection, a common problem with this particular anaesthetic agent. The aim of this study was to investigate whether using the mixture of propofol plus lignocaine had any adverse effects on ECT seizure expression (duration, and ictal quality). ⋯ The addition of a small dose of lignocaine to propofol during ECT treatment enhanced rather than reduced the quality of the seizures produced.
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The consumption of benzodiazepines and cyclopyrrolones has in recent years attracted considerable interest due to serious side effects. In twelve health care practices in Denmark a few simple rules to reduce the consumption were established. Telephone recipes were abolished, and prescriptions were issued for only a single month's usage and only following personal consultation. These rules are generally in accordance with recommendations applicable in, for example, England, Norway and Denmark. After 15 months, consumption was roughly halved. There is a general lack of knowledge about whether an intervention as described above leads to a substitution with other medicines. Here, especially antidepressants are in the spotlight. ⋯ The average prescription volume for the twelve health care practices corresponds to a relative decline. Fears that an intervention of the type mentioned above would lead to an uncontrollable increase in the consumption of antidepressants are unfounded.