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2.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763569

RESUMO

OBJECTIVE: To evaluate the effects of 2 different dose regimens of propofol (low dose: 25 sn) during the course of ECT in higher propofol doses. Although there was an increase in the seizure threshold over the course of ECT in both groups, this increase was found to be much more pronounced in the high-dose propofol group according to the low-dose propofol group. Longer duration of seizures was observed in the low-dose propofol group. CONCLUSION: Higher doses of propofol in induction of anesthesia can lead to a more progressive rise in seizure threshold than lower doses of propofol.


Assuntos
Anestesia , Eletroconvulsoterapia , Registros Eletrônicos de Saúde , Humanos , Propofol , Estudos Retrospectivos , Convulsões
3.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763562

RESUMO

Schizophrenic patients resistant to antipsychotics are diagnosed as having treatment-refractory schizophrenia, and they are treated with clozapine. However, clozapine is sometimes combined with electroconvulsive therapy (ECT) if clozapine monotherapy fails. In this report, a severe treatment-refractory schizophrenic patient who did not respond to clozapine even with ECT, but who recovered with asenapine monotherapy, is presented. Asenapine, considered a serotonin spectrum dopamine modulator, is a new atypical antipsychotic with unique pharmacological features that is used not only for schizophrenia, but also for bipolar disorder. The unique features of asenapine may be effective for some treatment-refractory schizophrenic patients.


Assuntos
Antipsicóticos , Transtorno Bipolar , Clozapina , Dopamina , Eletroconvulsoterapia , Humanos , Recidiva , Esquizofrenia , Serotonina , Suicídio
4.
Psychiatry Investigation ; : 704-712, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760977

RESUMO

OBJECTIVE: The present study aimed to report the initial seizure threshold (IST) of a brief-pulse bilateral electroconvulsive therapy (BP-BL ECT) in Korean patients with schizophrenia/schizoaffective disorder and to identify IST predictors. METHODS: Among 67 patients who received ECT and diagnosed with schizophrenia/schizoaffective disorder based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, we included 56 patients who received 1-millisecond BP-BL ECT after anesthesia with sodium thiopental between March 2012 and June 2018. Demographic and clinical information was gathered from electronic medical records, and a multiple regression analysis was conducted to identify predictors of the IST. RESULTS: The mean age of the patients was 36.9±12.0 years and 30 (53.6%) patients were male. The mean and median IST were 105.9±54.5 and 96 millicoulombs (mC), respectively. The IST was predicted by age, gender, and dose (mg/kg) of sodium thiopental. Other physical and clinical variables were not associated with the IST. CONCLUSION: The present study demonstrated that the IST of 1-ms BP-BL ECT following sodium thiopental anesthesia in Korean patients was comparable to those reported in previous literature. The IST was associated with age, gender, and dose of sodium thiopental.


Assuntos
Anestesia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Eletroconvulsoterapia , Registros Eletrônicos de Saúde , Humanos , Masculino , Transtornos Psicóticos , Esquizofrenia , Convulsões , Sódio , Tiopental
5.
Psychiatry Investigation ; : 479-483, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760963

RESUMO

Antidepressants usually require 2–8 weeks after drug administration to obtain a clinical response. In contrast, three fast-acting antidepressant treatments (sleep deprivation, electroconvulsive therapy, and ketamine) significantly reduced depressive symptoms within hours to days in a subgroup of patients with depressive disorder. This review addresses the mechanisms underlying these fast effects, with specific focus on treatment effects on circadian rhythms. Numerous recent studies have shown that circadian dysregulation may play an important role in the pathogenesis of mood disorders. These studies indicate that a common therapeutic mechanism underlying the three fast antidepressant therapies is related to circadian rhythm. Evidence suggests that depressive disorder is associated with circadian rhythm delay and that the mechanism of the antidepressant effect is a process in which the delayed circadian rhythm is restored to normal by the treatment.


Assuntos
Antidepressivos , Transtornos Cronobiológicos , Ritmo Circadiano , Depressão , Transtorno Depressivo , Eletroconvulsoterapia , Humanos , Ketamina , Transtornos do Humor , Privação do Sono
6.
Psychiatry Investigation ; : 464-468, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760945

RESUMO

To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini-Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow-up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.


Assuntos
Ansiedade , Atropina , Cognição , Transtornos Cognitivos , Depressão , Transtorno Depressivo Maior , Terapia por Estimulação Elétrica , Eletroconvulsoterapia , Seguimentos , Humanos
7.
Med. U.P.B ; 37(1): 25-35, ene. 2018.
Artigo em Inglês | LILACS (Américas) | ID: biblio-878937

RESUMO

Objetivo: la terapia electroconvulsiva (TEC) se ha considerado un tratamiento seguro y eficaz para episodios de depresión mayor, para episodios maníacos y otros trastornos psiquiátricos serios. El estudio describe los efectos cognitivos de la TEC en pacientes referidos para tratamiento a una clínica privada. Metodología: estudio descriptivo del tipo de serie de casos. En cada participante se realizó una evaluación basal antes del inicio de la TEC y otras dos (una a la semana y otra a los seis meses) después de terminado el ciclo de tratamientos, para describir el efecto de la TEC frontotemporal bilateral en la función neurocognitiva mediante el cambio, desde el estado basal hasta la evaluación final en los dominios de memoria, velocidad psicomotora, tiempo de reacción, atención compleja y flexibilidad cognoscitiva, así como en la función cognoscitiva global; y determinar su seguridad por el reporte de eventos adversos. La evaluación cognitiva se realizó con una batería de pruebas neuropsicológicas y la severidad de la enfermedad psiquiátrica se evaluó con la escala Clinical Global Impression Severity (CGI-S). Se incluyeron seis pacientes remitidos para tratamiento durante el periodo de seis meses. Resultados: no se observaron diferencias estadísticamente significativas entre las medianas de las evaluaciones de CGI-S, ni de la función cognitiva global, así como de ninguno de los dominios evaluados. Conclusiones: la TEC no produjo cambios en las funciones cognitivas analizadas en los seis pacientes estudiados.


Objective: Electroconvulsive therapy (ECT) has been considered a safe and effective treatment for depression, manic episodes, and other serious psychiatric conditions. Its main reported side effect has been cognitive impairment. This study describes the cognitive effects of ECT in psychiatric patients referred for treatment at a private clinic. Methodology: Descriptive case series study. A baseline assessment conducted before starting ECT, and another two (at one week and at six months) after completing the treatment cycle were used to describe the effects of frontotemporal bilateral ECT on neurocognitive function in terms of the change from the baseline to the final assessment in the domains of memory, psychomotor speed, reaction time, complex attention, and cognitive flexibility, as well as global cognitive function, as well as to determine ECT's safety by reporting adverse events. Cognitive assessment was conducted with a neuropsychological test battery and severity of psychiatric illness with the Clinical Global Impression-Severity scale (CGI-S). Six patients referred for treatment during six months were included. Results: No statistically significant differences were observed between the medians of the evaluations of CGI-S scale, global cognitive function or any of the domains evaluated. Conclusions: ECT did not produce changes in the cognitive functions assessed in the six studied patients.


Objetivo: a terapia eletroconvulsiva (TEC) se há considerado um tratamento seguro e eficaz para episódios de depressão maior, para episódios maníacos e outros transtornos psiquiátricos sérios. O estudo descreve os efeitos cognitivos da TEC em pacientes referidos para tratamento a uma clínica privada. Metodologia: estudo descritivo do tipo de série de casos. Em cada participante se realizou uma avaliação basal antes do início da TEC e outras dois (uma em uma semana e outra aos seis meses) depois de terminado o ciclo de tratamentos, para descrever o efeito da TEC frontotemporal bilateral na função neurocognitiva mediante a mudança, desde o estado basal até a avaliação final nos domínios de memória, velocidade psicomotora, tempo de reação, atenção complexa e flexibilidade cognoscitiva, assim como na função cognoscitiva global; e determinar sua segurança pelo reporte de eventos adversos. A avaliação cognitiva se realizou com uma bateria de provas neuropsicológicas e a severidade da doença psiquiátrica se avaliou com a escala Clinical Global Impression Severity (CGI-S). Se incluíram seis pacientes remitidos para tratamento durante o período de seis meses. Resultados: não se observaram diferencias estatisticamente significativas entre as média das avaliações de CGI-S, nem da função cognitiva global, assim como de nenhum dos domínios avaliados. Conclusões: a TEC não produziu mudanças nas funções cognitivas analisadas nos seis pacientes estudados.


Assuntos
Eletroconvulsoterapia
8.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-739458

RESUMO

OBJECTIVE: In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. METHODS: Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. RESULTS: AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. CONCLUSION: The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased.


Assuntos
Adulto , Idoso , Antipsicóticos , Terapia Biológica , Consenso , Depressão , Depressão Pós-Parto , Transtorno Depressivo , Transtorno Depressivo Maior , Tratamento Farmacológico , Eletroconvulsoterapia , Feminino , Humanos , Transtornos do Humor , Gestantes , Transtorno Disfórico Pré-Menstrual , Estimulação Magnética Transcraniana
9.
REVISA (Online) ; 7(3): 235-247, 2018.
Artigo em Português | LILACS (Américas) | ID: biblio-1097563

RESUMO

Analisou as implicações éticas e legais da realização da ECT; Evidenciar as divergências de concepções entre os grupos que apoiam a ECT entre os que a condenam; destacar evidências sobre a eficácia do tratamento e identificar a participação da enfermagem em sua aplicação. Metodologia: Trata-se de uma pesquisa bibliográfica, realizada no período de 2001 a 2017 com 12 publicações obtidas nas bases de dados das Bibliotecas Virtuais BDENF, BVS, MEDLINE e SCIELO. Resultados: É um tratamento reconhecido pelo Conselho Federal de Medicina e Associação Brasileira de Psiquiatria, sua aplicabilidade requer que se cumpram exigências estabelecidas no protocolo de execução deste tratamento. Aspectos éticos, não foram claramente tratados pelos estudos. A ECT tem uma história de abusos que não é negada nem por seus próprios defensores, porém, quando prescrita de forma adequada, há eficácia com o tratamento. O papel da enfermagem na aplicação do tratamento é pouco relatado, e está mais relacionada aos cuidados pré e pós desenvolvimento da técnica. Considerações: Há um estigma do uso do eletrochoque que ainda predomina na sociedade em geral. Mais que uma prática técnica, a ECT necessita ser discutida como um tratamento que gera rejeições e que traz um marco histórico de punições e dor social. Se hoje ela tem sua relevância e se tornou uma aplicação criteriosa e ética, é necessário que estas questões sejam respeitosamente enfrentadas e discutidas na sociedade.


Assuntos
Eletroconvulsoterapia
10.
Psychiatry Investigation ; : 829-835, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-716458

RESUMO

OBJECTIVE: This study aimed to investigate the effectiveness and tolerability of the combination of electroconvulsive therapy (ECT) in patients with clozapine-treated schizophrenia. METHODS: Patients with clozapine-treated schizophrenia during five years of pre-determined period were recruited from Electronic Medical Record. Clinical effects of acute ECT on psychotic symptoms were investigated. We also tried to identify predictive variables requiring maintenance treatment of ECT. RESULTS: Fourteen patients received ECT and clozapine and sixteen were treated with clozapine alone. In the ECT group, which could be refined as clozapine-resistance, PANSS total score was significantly reduced by 19.0±9.9 points, corresponding to a reduction rate of 18.5±8.3%. The clinical remission defined as 20% PANSS reduction criteria was achieved at 42.9%. The subscale factors were significantly reduced, among which the negative symptom was the least. There was no difference in demographic and clinical information between patients receiving and not receiving maintenance ECT, and not all patients seemed to need maintenance ECT if clozapine is continued. CONCLUSION: Combination of ECT and clozapine in patients with clozapine-resistant schizophrenia resulted in a rapid and substantial reduction of psychotic symptoms. Further studies are needed to improve the effectiveness and tolerability of ECT.


Assuntos
Clozapina , Eletroconvulsoterapia , Registros Eletrônicos de Saúde , Humanos , Esquizofrenia
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-716367

RESUMO

OBJECTIVE: Continuation-maintenance electroconvulsive therapy (C/M-ECT) is used to prevent relapse or recurrence in patients with severe mental illnesses. We aimed to investigate the effect of C/M-ECT on reducing hospital re-admissions in patients with treatment-resistant schizophrenia. METHODS: We applied a mirror-image design by retrospectively examining re-hospitalization rates of 18 patients with schizophrenia spectrum disorders. We compared the numbers of psychiatric admissions during the actual period over which C/M-ECT was administered with the same period prior to the beginning of C/M-ECT. RESULTS: The number of psychiatric admissions was reduced significantly during C/M-ECT (0.33±0.77) compared with that of the same period prior to C/M-ECT (2.67±1.33) (Wilcoxon signed rank Z=−3.663; p < 0.001). CONCLUSION: This finding shows that C/M-ECT augmentation could successfully reduce the re-hospitalization rates in patients with treatment-resistant schizophrenia.


Assuntos
Eletroconvulsoterapia , Hospitalização , Humanos , Recidiva , Estudos Retrospectivos , Esquizofrenia
12.
Psychiatry Investigation ; : 655-655, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-715608

RESUMO

No abstract available.


Assuntos
Ritmo Circadiano , Eletroconvulsoterapia
13.
Psychiatry Investigation ; : 717-726, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-715599

RESUMO

OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for mood disorders. Accumulating evidence has suggested the important role of circadian genes in mood disorders. However, the effects of ECT on circadian genes have not been systemically investigated. METHODS: We examined the expression and daily oscillation of major circadian genes in the rat frontal cortex after electroconvulsive seizure (ECS). RESULTS: Firstly, mRNA and protein level were investigated at 24 hr after single ECS (E1X) and repeated ECS treatements for 10 days (E10X), which showed more remarkable changes after E10X than E1X. mRNA expression of Rorα, Bmal1, Clock, Per1, and Cry1 was decreased, while Rev-erbα expression was increased at 24 hr after E10X compared to sham. The proteins showed similar pattern of changes. Next, the effects on oscillation and rhythm properties (mesor, amplitude, and acrophase) were examined, which also showed more prominent changes after E10X than E1X. After E10X, mesor of Rorα, Bmal1, and Cry1 was reduced, and that of Rev-erbα was increased. Five genes, Rev-erbα, Bmal1, Per1, Per2, and Cry2, showed earlier acrophase after E10X. CONCLUSION: The findings suggest that repeated ECS induces reduced expression and phase advance of major circadian genes in the in vivo rat frontal cortex.


Assuntos
Animais , Ritmo Circadiano , Eletroconvulsoterapia , Lobo Frontal , Transtornos do Humor , Ratos , RNA Mensageiro , Convulsões
14.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 15(3): 99-110, Dic. 2017. ilus, tab
Artigo em Espanhol | LILACS (Américas), BDNPAR | ID: biblio-907827

RESUMO

Los psicofármacos y la psicoterapia son efectivos para muchos pacientes aquejados de trastornos mentales o problemáticas psicosociales. No obstante, algunos pacientes no responden a estas intervenciones, por lo que se necesitan de otras propuestas basadas en tratamientos biológicos (no farmacológicos). Estas técnicas se han ido desarrollando gracias a una mejor comprensión de los modelos neurofisiológicos y neuroanatómicos del humor, pensamiento y regulación del comportamiento, así como de estrategias más avanzadas para la modificación de la actividad neural. Con base en lo anterior, el objetivo de este artículo es presentar una actualización sobre los conceptos e indicaciones de la terapia electroconvulsiva, de las técnicas de estimulación cerebral, de la fototerapia y de la privación terapéutica del sueño.


Psychotropic drugs and psychotherapy are effective for many patients suffering from mental disorders or psychosocial problems. However, some patients do not respond to these interventions, so other proposals based on biological (non-pharmacological) treatments are needed. These techniques have been developed thanks to a better understanding of the neurophysiological and neuroanatomic models of mood, thought process and behavioral regulation, as well as more advanced strategies for the modification of neural activity. Based on the above, the objective of this article is to present an update on the concepts and indications of electroconvulsive therapy, brain stimulation techniques, phototherapy and therapeutic sleep deprivation.


Assuntos
Eletroconvulsoterapia , Fototerapia , Privação do Sono , Estimulação Encefálica Profunda
16.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-788365

RESUMO

Many bipolar disorder patients exhibit mixed affective states, which portend a generally more severe illness course and treatment resistance. In the previous renditions of Diagnostic and Statistical Manual mixed states were narrowly defined in the context of bipolar I disorder, but with the advent of DSM-5 the term “mixed episode” was dropped and replaced by “mixed features” specifier which could be broadly applied to manic, hypomanic and depressive episodes in both the bipolar spectrum and major depressive disorders. This paradigm shift reflected their significance in the prognosis and overall management of mood disorders, so that the clinicians should thoroughly familiarize themselves with the contemporary notions surrounding these conditions. The purpose of this manuscript is to bring to light the current conceptualizations regarding the etiology, pathogenesis and treatment of mixed states. To achieve this goal, in June 2016 an extensive literature search was undertaken using the PubMed database. Some exploratory terms utilized included “mixed states”, “mixed episodes”, “switching”, “rapid cycling” cross referenced with “bipolar disorder”. Focusing on the most relevant and up to date studies, it was revealed that mixed states result from genetic susceptibility in the circadian and dopamine neurotransmission apparatuses and disturbance in the intricate catecholamine-acetylcholine neurotransmission balance which leads to mood fluctuations. The management of mixed states is challenging with atypical antipsychotics, newer anticonvulsants and electroconvulsive therapy emerging as the foremost treatment options. In conclusion, while progress has been made in the neurobiological understanding of mixed states, the currently available therapeutic modalities have only shown limited effectiveness.


Assuntos
Acetilcolina , Anticonvulsivantes , Antipsicóticos , Transtorno Bipolar , Catecolaminas , Transtorno Depressivo Maior , Dopamina , Eletroconvulsoterapia , Predisposição Genética para Doença , Humanos , Transtornos do Humor , Prognóstico , Transmissão Sináptica
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-152987

RESUMO

Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT.


Assuntos
Encéfalo , Eletroconvulsoterapia , Sistema Imunitário , Transtornos Mentais , Neurobiologia , Permeabilidade , Usos Terapêuticos
19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-41580

RESUMO

OBJECTIVE: Electroconvulsive therapy (ECT) is used in the treatment of many psychiatric diseases and this therapy may be effective on antioxidant defence system. In this study, we aimed to evaluate the effects of ECT on oxidative stress. METHODS: Fourteen major depression, 11 schizophrenia and 8 bipolar affective disorder patients diagnosed and received ECT treatment, and 37 healthy volunteers enrolled in the study. ECT was applied to all patients. Before ECT, after the first and last ECTs, serum samples were obtained. Serum total antioxidant status (TAS), total oxidant status (TOS), and calculated oxidative stress index (OSI) were measured in patients before and after ECTs. RESULTS: TOS values before ECT were higher in major depression (p=0.005) and schizophrenia (p=0.001) groups compared to the control group. TAS values were lower in major depression (p=0.0001), schizophrenia (p=0.004), bipolar affective disorder (p=0.004) groups compared to the controls. Also OSI values were higher in major depression (p=0.0001), schizophrenia (p=0.001), bipolar affective disorder (p=0.009) groups compared to healthy group. After the last ECT, TOS values were significantly lower compared to TOS values before ECT in major depression (p=0.004) and schizophrenia patients (p=0.004). TAS values after the first ECT were higher compared to values before ECT in major depression patients (p=0.004). After last ECT, OSI values were significantly lower compared to before ECT in schizophrenia patients (p=0.006). CONCLUSION: As a result, it can be said that ECT did not increase oxidative stress. However, further studies with more patients are needed.


Assuntos
Depressão , Eletroconvulsoterapia , Voluntários Saudáveis , Humanos , Transtornos do Humor , Estresse Oxidativo , Esquizofrenia
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-222872

RESUMO

Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. Symptomatically, psychomotor retardation, lack of energy, and apathy tends to be more common in people with late-onset depression (LOD). Despite recent advances in psychopharmacologic treatments, 20% to 30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However, the therapeutic mechanism of ECT is still unclear. By using ¹⁸F-fluorodeoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT), we can obtain the status of brain metabolism in patients with neuropsychiatric disorders and changes during psychiatric treatment course. The object of this case report is evaluating the effect of ECT on brain metabolism in treatment-refractory LOD by PET/CT and understanding the mode of action of ECT. In this case report, we presented a 55-year-old female patient who suffered psychotic depression that was resistant to pharmacological treatment. Several antidepressants and atypical anti-psychotics were applied but there was no improvement in her symptoms. The patient presented not only depressed mood and behaviors but also deficit in cognitive functions. We found decreased diffuse cerebral metabolism in her brain ¹⁸F-FDG PET/CT image. ECT resulted in amelioration of the patients' symptoms and another brain PET imaging 7 weeks after the last ECT course showed that her brain metabolism was normalized.


Assuntos
Antidepressivos , Apatia , Encéfalo , Cognição , Depressão , Transtorno Depressivo Maior , Eletroconvulsoterapia , Elétrons , Feminino , Fluordesoxiglucose F18 , Humanos , Metabolismo , Pessoa de Meia-Idade , Transtornos do Humor , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons
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