Resource Tag: ELECTROCONVULSIVE THERAPY

The authors argue that the prognosis for elderly depressed patients can be good. They review a variety of treatment options, including drug therapy, psychotherapy, antidepressant regimen treatment, & electroconvulsive therapy. Risk of suicide is discussed. (26 refs)

The authors investigated & compared the effects of Selective Serotonin Reuptake Inhibitors (SSRIs) & tricyclic antidepressants (TCAs) on seizure duration after the first bilateral Electroconvulsive Therapy (ECT). In patient groups diagnosed with major depressive disorder & matched for age & sex, the authors found no significant difference between the seizure duration following initial ECT treatments […]

The epidemiology of suicidal behaviour in the elderly is explored, & considerations specific to suicide in this population are reviewed. An overview of risk factors associated with elderly suicide is provided, & issues in the assessment & treatment of suicidal patients in later life are examined. Finally, the treatment of late-life depression is discussed in […]

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The authors present new data & review clinical experience that indicate that electroconvulsive therapy (ECT) often exerts a profound short-term beneficial effect on suicidality. They argue that little, if any, evidence supports a long-term positive effect of ECT on suicide rates. They also find that on the whole, the published reports are weakened by methodological […]

Because of the flood of biological data that has been reported in recent years, the challenge to the ordinary clinician has entailed both the effort to remain abreast of this rapidly growing body of technical information, & to determine its usefulness in the everyday task of patient evaluation, treatment & management. The present discussion addresses […]

The authors review a variety of pharmacologic interventions aimed at reducing the risk of suicide among mentally ill patients, including antidepressants, electroconvulsive therapy, antipsychotic drugs, & lithium. They find that lithium is the only medication for which the evidence consistently shows an antisuicidal effect. (24 refs)

Depression affects 10-15% of people over 65 living at home in the United Kingdom. It is the commonest and the most reversible mental health problem in old age. Depression is associated with physical illness and disability, life events, social isolation and loneliness. Depression in old age carries an increased risk of suicide and natural mortality. […]

Dr Salzman discusses the use of psychotropic drugs and shock therapy in treating suicidal patients. He explores the use of various medications such as tricyclic anti-depressants and serotonin inhibitors, and describes the chemical makeup of suicide victims at the time of death. Salzman says the exact benefits of medication and therapy treatments are still unknown. […]

Electroconvulsive therapy is used most frequently to treat medication-resistant depression. Other indications for this treatment include severe depression with suicidal ideation, acute mania & severe psychiatric illness with food & fluid refusal. This article outlines the efficacy of electroconvulsive therapy, procedure, medical evaluation prior to treatment, the management of medically high-risk patients, & adverse effects. […]

An adult female patient without previous history of pain or psychiatric disorder developed reflex sympathetic dystrophy in her left hand & arm after 2 separate injuries & subsequent surgeries. Traditional biomedical therapies were unsuccessful. Several weeks after hospitalization the patient attempted suicide. Electroconvulsive therapy was administered using bilateral lead placement. Over the course of this […]

The differential diagnosis of self-destructive behaviour is discussed in the context of growing awareness of how, when coupled with contributing factors, these disorders lead to suicide in individuals with the biogenetic basis for self-destructive behaviour. The implications of these factors for the treatment of suicidal patients is reviewed. The use of drug therapies, accompanied by […]

This chapter discusses recognition of the suicidal elderly person & specific risk factors including a previous suicide attempt, family history of suicide, bereavement, alcoholism, physical illness, personality disorders, depressive illnesses, schizophrenia, dementia, hopelessness, & biological factors. Antidepressant drugs & electroconvulsive therapy are discussed as possible means of managing the suicidal elderly person. 5 case profiles […]

This chapter focuses on the elderly institutionalized in nursing homes & other long-term care facilities & their special problems & concerns. Factors that contribute to suicide in this population are examined. In addition to the more frequently used medication & psychotherapeutic interventions, newer techniques are discussed including the use of humor therapy, therapeutic touch, & […]

A nurse’s personal perspectives on suicide ideation as experienced in part due to traumatic life events. Through her personal experiences she has gained a broader understanding of the pathology, symptoms, & treatment of psychiatric disorders that influence her own research, teaching, and practice. This paper is a narrative of the events and feelings surrounding her […]

In this letter to the editor, the authors question why a previous review by Montgomery et al (see SIEC #920749) failed to mention the use of electroconvulsive therapy (ECT) as a treatment for suicidal behaviours. The present authors discuss the efficacy & safety of ECT in the treatment of depressed patients with suicidal ideation & […]

Evidence is provided which shows that depression is an often chronic & recurrent illness. Well-established recommendations for the treatment of depression & maintenance treatments are described. The author briefly reviews problems, including suicide & parasuicide, that are commonly associated with continued antidepressant therapy. Finally, the discontinuation of treatment, which should be accomplished with the patient […]

The case history of an elderly woman who suffered from concurrent serious psychiatric & medical illnesses is presented. At initial presentation, the patient was passively suicidal. Ethical considerations concerning the patient’s treatment are discussed with special attention to her requests for both ECT & do-not-resuscitate status. This case illustrates a conflict between medical & psychiatric […]

Several alternative strategies for helping depressed patients who have not responded to initial therapy are offered. Enhancing existing drug therapy is usually more advantageous than starting over with a new medication because of the shorter response time. A structurally different antidepressant is more likely to induce a remission than a medication of similar configuration. ECT […]

Patients with simultaneous depression & panic disorder may have a higher lifetime rate of suicide attempts & an overall worse prognosis than patients with either depression or panic disorder alone. The clinical courses of 8 consecutive patients who were referred for ECT are described. 6 presented with suicidal ideation & 2 had a history of […]

This article outlines how to recognize depression & assess suicidal intent in the elderly. Medical causes & treatments of depression are also detailed, including tricyclic & heterocyclic agents, monoamine oxidase inhibitors, lithium, psychostimulants, & electroconvulsive therapy. Side effects, & food & drug interactions are described for each drug. Finally, special treatments for cardiac & stroke […]