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Position statement and guidelines on unmodified electroconvulsive therapy
BACKGROUND: In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440905/ https://www.ncbi.nlm.nih.gov/pubmed/22988318 http://dx.doi.org/10.4103/0019-5545.99530 |
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author | Andrade, Chittaranjan Shah, N. Tharyan, P. Reddy, M. S. Thirunavukarasu, M. Kallivayalil, R. A. Nagpal, R. Bohra, N. K. Sharma, A. Mohandas, E. |
author_facet | Andrade, Chittaranjan Shah, N. Tharyan, P. Reddy, M. S. Thirunavukarasu, M. Kallivayalil, R. A. Nagpal, R. Bohra, N. K. Sharma, A. Mohandas, E. |
author_sort | Andrade, Chittaranjan |
collection | PubMed |
description | BACKGROUND: In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of unmodified ECT in developing countries and, to a small extent, in the developed world, as well. MATERIALS AND METHODS: This document examines historical and recent literature on the geographical practice, physiology, efficacy, and adverse effects of unmodified ECT. Particular attention is paid to musculoskeletal risks. RESULTS: Although almost all the research is of poor methodological quality, there is a good reason to accept that unmodified ECT is associated with a wide range of adverse consequences, important among which are musculoskeletal complications, pre-ECT anxiety, and post-ECT confusion. However, it appears from recent data that these risks are not as large as historically portrayed. Possibly explanations are suggested, with seizure modification using parenteral benzodiazepines as a special possibility. CONCLUSIONS: Under exceptional circumstances, if ECT is strongly indicated and seizure modification with succinylcholine is not feasible, unmodified ECT, especially benzodiazepine-modified ECT, may be a viable option. A detailed set of recommendations for such use of unmodified ECT is proposed along with necessary checks and balances. This document has been approved by the Indian Psychatric Society, the Indian Association of Biological Psychiatry, and the Indian Association of Private Psychiatry (which commissioned the preparation of the document). |
format | Online Article Text |
id | pubmed-3440905 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-34409052012-09-17 Position statement and guidelines on unmodified electroconvulsive therapy Andrade, Chittaranjan Shah, N. Tharyan, P. Reddy, M. S. Thirunavukarasu, M. Kallivayalil, R. A. Nagpal, R. Bohra, N. K. Sharma, A. Mohandas, E. Indian J Psychiatry Special Article BACKGROUND: In modern day psychiatric practice, it is assumed as a matter of fact that when electroconvulsive therapy (ECT) is administered, it will be administered under anesthesia and with succinylcholine (or its equivalent) modification. Yet, as surveys indicate, there is considerable practice of unmodified ECT in developing countries and, to a small extent, in the developed world, as well. MATERIALS AND METHODS: This document examines historical and recent literature on the geographical practice, physiology, efficacy, and adverse effects of unmodified ECT. Particular attention is paid to musculoskeletal risks. RESULTS: Although almost all the research is of poor methodological quality, there is a good reason to accept that unmodified ECT is associated with a wide range of adverse consequences, important among which are musculoskeletal complications, pre-ECT anxiety, and post-ECT confusion. However, it appears from recent data that these risks are not as large as historically portrayed. Possibly explanations are suggested, with seizure modification using parenteral benzodiazepines as a special possibility. CONCLUSIONS: Under exceptional circumstances, if ECT is strongly indicated and seizure modification with succinylcholine is not feasible, unmodified ECT, especially benzodiazepine-modified ECT, may be a viable option. A detailed set of recommendations for such use of unmodified ECT is proposed along with necessary checks and balances. This document has been approved by the Indian Psychatric Society, the Indian Association of Biological Psychiatry, and the Indian Association of Private Psychiatry (which commissioned the preparation of the document). Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3440905/ /pubmed/22988318 http://dx.doi.org/10.4103/0019-5545.99530 Text en Copyright: © Indian Journal of Psychiatry http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Special Article Andrade, Chittaranjan Shah, N. Tharyan, P. Reddy, M. S. Thirunavukarasu, M. Kallivayalil, R. A. Nagpal, R. Bohra, N. K. Sharma, A. Mohandas, E. Position statement and guidelines on unmodified electroconvulsive therapy |
title | Position statement and guidelines on unmodified electroconvulsive therapy |
title_full | Position statement and guidelines on unmodified electroconvulsive therapy |
title_fullStr | Position statement and guidelines on unmodified electroconvulsive therapy |
title_full_unstemmed | Position statement and guidelines on unmodified electroconvulsive therapy |
title_short | Position statement and guidelines on unmodified electroconvulsive therapy |
title_sort | position statement and guidelines on unmodified electroconvulsive therapy |
topic | Special Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440905/ https://www.ncbi.nlm.nih.gov/pubmed/22988318 http://dx.doi.org/10.4103/0019-5545.99530 |
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