MDD - Roger Peele
... opposed to pt preferring psychotherapy]
moderate: antidepressants meds are preferred
[unless ECT is planned]
severe: antidepressant meds are preferred
[unless ECT is planned]
severe with psychotic signs: antidepressants
AND antipsychotics [unless ECT is planned]
Catatonia: a critical review and therapeutic
... sions. These patients often present with an association of
catatonic symptoms and signs, usually more than 5; the
most frequent symptoms are mutacism (68% of cases),
and negativism or psychomotor arrest (62% of cases) 35.
Uncertainty about the nature and diagnostic relevance of
catatonia certainly d ...
Catatonia: a critical review and therapeutic recommendations
... there are 12 possible clinical manifestations (psychomotor arrest with catalepsy, waxy flexibility or stupor, tendency for fixed posture, echolalia, echopraxia, psychomotor agitation, negativism, mutacism, motor stereotypies, mannerisms, grimaces), which according to some
authors 47 constitute an in ...
The Johns hopkins medicine Library
... Because manic episodes in particular can cause impaired judgment, people must be protected from engaging in self-destructive actions, such as making unwise investments, going
on large spending or gambling sprees, driving recklessly, or impulsively starting intense
and unwise romantic or sexual relat ...
MJP 2008, Vol.17 No - Malaysian Journal of Psychiatry
... parasuicide varied substantially across
16 different sites (5). In other
registration studies, the rates varied
widely from 2.6 to 542 per 100,000
populations (1). However the process of
data collection also varied among the
sites which could have influenced the
Similar to the WHO study, the l ...
... electrical activity by augmenting the affect of GABA, an inhibitory neurotransmitter.
They are fast acting and can affect anxiety following a single dose. Although useful in
treating anxiety disorder, insomnia, PTSD and panic disorder, they are highly
addictive, interact dangerously with alcohol and ...
May 2010 What is the CIMR?
... the final year of his Psychiatry residency at the
University of Toronto. He also recently completed
a concurrent fellowship in neuroeconomics (the
neuroscience of decision-making) at Baylor College
of Medicine in Houston, Texas. Alongside his psychiatry training, he
has conducted research on the fun ...
Treatment guidelines for bipolar disorder: A critical review
... as well as psychodynamic psychotherapy may be used
in addition to pharmacotherapy (II), although empirical studies are inconclusive. During the maintenance
phase, it is suggested that patients are likely to benefit
from the application of a concomitant psychosocial
intervention (II). Psychoeducation ...
Treatments for Mood Disorders
... (a) The use of ECT was and is controversial
(i) It now is used frequently because it is an effective and fast-acting intervention
(b) The procedure consists of targeted electrical stimulation to cause brain
(c) The usual course of treatment is 6 to 12 sessions spaced over two to four
When clinical psychosis accompanies depression
... antipsychotic therapy.3 It has also been demonstrated that
bilateral ECT is more effective than unilateral ECT. Given
the high relapse rate associated with ECT, the literature supports the use of pharmacotherapy for maintenance
treatment and prophylaxis even when ECT has been successfully applied.3
Treatment of Major Depressive Disorder with Psychosis
... Minimal evidence for treating major depressive disorder (MDD) with mixed features
Discuss treatment options, including evidence-based psychotherapy [Cognitivebehavioral therapy (CBT), Interpersonal psychotherapy (IPT)]
Consider second generation antipsychotic (SGA) or mood stabilizer (e.g. lithium)
Depression and Anxiety Disorders
... Mood and anxiety disorders are common, and the mortality risk is due primarily to suicide,
cardiovascular disease, and substance abuse. Risk is highest early in the course of the disorder or
within 2 years of a hospitalization.
Mood disorders are divided into Depressive Disorders (unipolar) and Bipo ...
Focus On Vocabulary Chapter 15
... (ECT) has proven quite effective and is still used mainly for chronically depressed people
who have not responded to drug therapy. In 1938, when ECT was first introduced, wideawake patients were strapped to a table to prevent them from hurting themselves during
the convulsions. These patients were s ...
Depression and Anxiety Disorder
... Drug therapy (with or without counseling) is effective in treating most individuals. The mainstay
of therapy for both anxiety and mood disorders is antidepressant drugs. For more severe cases,
electroconvulsive therapy (ECT) or anti-psychotic agents may be required. If anxiety is present,
Department of Psychiatry and Behavioral Sciences at University of Miami
... from other specialties including cardiology, neurology, and anesthesiology, as
needed. By integrating this information,
we provide a comprehensive assessment,
and recommendations regarding
ECT has undergone rapid evidence-based technical improvements since it was first introduced over ...
Management of treatment- resistant depression
... explored with patients and they should be prescribed an adequate trial of an antidepressant. This would usually be for six to 12
weeks, however, if there is little response after four to six weeks,
it is advised to move to the next treatment step.
The STAR*D trial, (Sequenced Tr ...
electroconvulsive therapy and older adults
... • Risk of alternative treatments outweighs risks of
• History of poor response to medications
• History of intolerable side effects to medications
• History of good response to ECT
• Patient preference of ECT over alternatives
Do Antidepressants Work Better Than Placebos? electroconvulsive
... Antidepressants were found to work better than placebos for
some patients—but only those with very high levels of depression,
the area shown in blue. Except in that area, the difference between
the lines could have simply occurred by chance. Overall, according
to Kirsch and his colleagues, about 80 ...
Indications for the Use of Electroconvulsive Therapy (ECT)
... should be done as close to the first treatment
session as possible.
• Both psychiatric and medical assessments are
needed to conduct a risk–benefit analysis for the
treatment of an individual patient.
• Establishing the indications for ECT include a
careful diagnosis, as well as consideration of
Transcranial Magnetic Stimulation
... pulses on the left) were effective in relieving mania. Other studies are investigating the
effect in schizophrenia and obsessive-compulsive disorder.
Pinhas Dannon, M.D. and his colleagues reported on a study of 20 severely depressed
patients who received either traditional electroconvulsive therapy ...
Details (Ao1) and Evaluation (Ao2) of treatments for abnormality
... temples, usually just one electrode on the nondominant hemisphere (usually the right hand side)
• An electric current of 70-130 volts is passed
through the brain for 30 seconds
• This induces a convulsion (a seizure similar to an
epileptic fit) that lasts for about a minute
• Once the patient comes ...
History of electroconvulsive therapy in the United Kingdom
Electroconvulsive therapy (ECT, in the past sometimes called electric convulsion therapy, convulsion treatment or electroplexy) is a controversial psychiatric treatment in which seizures are induced with electricity. ECT was first used in the United Kingdom in 1939 and, although its use has been declining for several decades, it was still given to about 11,000 people a year in the early 2000s.In contemporary psychiatric practice, ECT is used mainly in the treatment of depression. It is occasionally used in the treatment of other disorders such as schizophrenia. When undergoing modern ECT, a patient is given an anaesthetic and a muscle relaxant. A brief-pulse electric current of about 800 milliamperes is passed between two electrodes on the head for several seconds, causing a seizure. The resulting convulsion is modified by the muscle relaxant. ECT is usually given on an inpatient basis; about one in five treatments are given on an outpatient basis. Treatment is usually given twice a week (occasionally three times a week) for a total of 6–12 treatments, although courses may be longer or shorter. About 70 per cent of ECT patients are women. About 1,500 ECT patients a year in the UK are treated without their consent under the Mental Health Acts or the provisions of common law.