Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Andrade, Chittaranjan, Shah, N., Tharyan, P., Reddy, M. S., Thirunavukarasu, M., Kallivayalil, R. A., Nagpal, R., Bohra, N. K., Sharma, A., Mohandas, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
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
_version_ 1782243204253351936
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
work_keys_str_mv AT andradechittaranjan positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT shahn positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT tharyanp positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT reddyms positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT thirunavukarasum positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT kallivayalilra positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT nagpalr positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT bohrank positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT sharmaa positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy
AT mohandase positionstatementandguidelinesonunmodifiedelectroconvulsivetherapy