Convulsive therapy
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Reliable, valid, and brief measures of mood state are essential to the evaluation of electroconvulsive therapy (ECT) efficacy. However, existing measures of mood state may be inappropriate for patients with transient cognitive impairment. Stern and colleagues have recently developed a set of Visual Analog Mood Scales (VAMS) for use in neurologically impaired patients. ⋯ Results indicate that the VAMS are as sensitive to the therapeutic effects of ECT as is the more lengthy and verbally demanding HDRS. In addition, the VAMS were highly correlated with the clinician's Clinical Global Improvement rating and the patient's self-report using a modified Center for Epidemiological Studies-Depression scale. The VAMS are brief, reliable scales that are sensitive to the treatment effects of ECT and that are appropriate for patients with transient cognitive impairment.
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Letter Randomized Controlled Trial Clinical Trial
Triazolam and diphenhydramine effects on seizure duration in depressed patients receiving ECT.
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The use of ketamine anesthesia in electroconvulsive therapy (ECT) has been limited by its effects on blood pressure and concerns about untoward psychological reactions. However, because its effect on seizures is presumably less than that of methohexital, ketamine is listed as an alternative method to prolong seizure length. In this case series, 10 patients were given ketamine anesthesia during ECT. ⋯ There were no adverse psychological reactions noted with ketamine, which was generally well tolerated. It is concluded that ketamine anesthesia with the doses used in this series is unlikely to be associated with longer seizures in ECT. However, for theoretical reasons discussed, ketamine may be worth studying further in ECT.