RESUMO
The safe administration of electroconvulsive therapy (ECT) in a man with steroid-induced depression and a history of craniotomy and gamma knife surgery for two separate foci of metastatic laryngeal cancer is reported. This is the first reported case of ECT given to a patient with a history of gamma knife surgery. The literature on ECT administration to patients with brain masses or a history of craniotomy is reviewed. The current case report indicates that with careful medical evaluation, including consultation with neurosurgeons and internal medicine physicians, ECT may be safely administered to this patient population.
Assuntos
Craniotomia , Transtorno Depressivo/terapia , Eletroconvulsoterapia , Radiocirurgia , Idoso , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Transtorno Depressivo/induzido quimicamente , Transtorno Depressivo/psicologia , Dexametasona/efeitos adversos , Dexametasona/uso terapêutico , Glucocorticoides/efeitos adversos , Glucocorticoides/uso terapêutico , Humanos , Neoplasias Laríngeas/patologia , MasculinoRESUMO
Sleep disturbances are a frequent complication of depressive disorders and their treatment. Familiarity with the interaction among sleep, depression, and antidepressant medications may assist the clinician in selecting agents to suit the needs of individual patients. The authors review the current knowledge of changes in sleep architecture associated with particular antidepressant agents and with depressive illness, as well as the theoretical relevance of such changes to the antidepressant effect. Articles for review were found through a Medline search on the terms "polysomnography," "sleep," "antidepressants," and "insomnia" in English-language papers published from 1966 through March 2000. Additional articles were found in the reference lists of relevant papers.