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Electroconvulsive Therapy: Pretreatment Medical Evaluation

Electroconvulsive Therapy: Pretreatment Medical Evaluation Abstract Electroconvulsive therapy (ECT) is finding increasing use in the therapy for psychiatric illness. This article reviews the physiological changes, potential complications, and drug interactions associated with ECT. The review provides the practitioner with guidelines for the evaluation and management of patients selected for ECT. Back to top Article Information Reprint requests to Division of General Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr Elliot). References 1. Frankel FH (ed): Report 14 on the American Psychiatric Association Task Force on convulsive therapy , in Electroconvulsive Therapy.. Washington, DC, American Psychiatric Association, 1978.Google Scholar 2. Fink M: Convulsive Therapy: Theory and Practice.. New York, Raven Press, 1979. 3. Brown ML, Huston PE, Hines HM, et al: Cardiovascular changes associated with electroconvulsive therapy in man. Arch Neurol. 1953;69:601-608. PubMedGoogle ScholarCrossref 4. Perrin GM: Cardiovascular and other physiologic changes accompanying EST. Acta Physiol Scand. 1961;36:10-45.Google Scholar 5. Bankhead AJ, Torrens JK, Harris TH: The anticipation and prevention of cardiac complications in electroconvulsive therapy. Am J Psychiatry. 1950;106:911-917. PubMedGoogle ScholarCrossref 6. Gravenstein JS, Anton AH, Wiener SM, et al: Catecholamine and cardiovascular response to electro-convulsion therapy in man. Br J Anaesth. 1965;37:833-839. PubMedGoogle ScholarCrossref 7. Anton AH, Uy DS, Redderson CL: Autonomic blockade and the cardiovascular and catecholamine response to electroshock. Anesth Analg. 1972;56:46-54. PubMedGoogle Scholar 8. Doba N, Beresford HR, Rets DJ: Changes in regional blood flow and cardiodynamics associated with electrically and chemically induced epilepsy in the cat. Brain Res. 1975;90:115-132. PubMedGoogle ScholarCrossref 9. Lewis WH Jr, Richardson DJ, Gahagan LH: Cardiovascular disturbances and their management in modified electrotherapy for psychiatric illness. N Engl J Med. 1955;252:1016-1020. PubMedGoogle ScholarCrossref 10. McKenna G, Engle RP Jr, Brooks H, et al: Cardiac arrhythmias during electroshock therapy: Significance, prevention, and treatment. Am J Psychiatry. 1978;127:172-175. PubMedGoogle Scholar 11. Pitts FN Jr, Desmarai GM, Steward W, et al: Induction of anesthesia with methohexital and thiopental in electroconvulsive therapy. N Engl J Med. 1965;273:353-360. PubMedGoogle ScholarCrossref 12. Green R, Woods A: Effects of modified ECT on the electrocardiogram. Br Med J. 1955;1:1503-1505. PubMedGoogle ScholarCrossref 13. Richardson J, Lewis WH, Gahagen LH, et al: Etiology and treatment of cardiac arrhythmias under anesthesia for electroconvulsive therapy. NY State J Med. 1959;57:881-886.Google Scholar 14. Weiner RD, Henschen GM, Dellasega M, et al: Propranolol treatment of ECT-related ventricular arrhythmias. Am J Psychiatry. 1979;136:1594-1595. PubMedGoogle ScholarCrossref 15. Bodley PO, Fenwick PBC: The effects of electroconvulsive therapy on patients with essential hypertension. Br J Psychiatry. 1966;112:1241-1249. PubMedGoogle ScholarCrossref 16. Foster MW Jr, Gayle RF Jr: Dangers in combining reserpine (Serpasil) with electroconvulsive therapy. JAMA. 1955;159:1520-1522. PubMedGoogle ScholarCrossref 17. Ciraulo D, Lind L, Salzman C, et al: Sodium nitroprusside treatment of ECT-induced blood pressure elevations. Am J Psychiatry. 1978;135:1105-1106. PubMedGoogle ScholarCrossref 18. Hussar AE, Pachter M: Myocardial infarction and fatal coronary insufficiency during electroconvulsive therapy. JAMA. 1968;204:146-149. PubMedGoogle ScholarCrossref 19. Goldman L, Caldera DL, Nussbaum SR, et al: Multifactorial index of cardiac risk in non-cardiac surgical procedures. N Engl J Med. 1977;297:845-850.Google ScholarCrossref 20. Youmans CR, Bourianoff G, Allensworth DC, et al: Cardiovascular alterations during electroconvulsive therapy in patients with cardiac pacemakers. South Med J. 1972;65:361-365. PubMedGoogle ScholarCrossref 21. Blitt CD, Kirschvink LJ: Electroconvulsive therapy with cardiac pacemakers. Anesthesiology. 1976;45:580.Google ScholarCrossref 22. Weinstein MR, Fischer A: Electroconvulsive treatment of a patient with artificial mitral and aortic valves. Am J Psychiatry. 1967;123:882-884. PubMedGoogle ScholarCrossref 23. Blumenthal IJ: Spontaneous seizures and related electroencephalographic findings following shock therapy. J Nerv Ment Dis. 1955;122:581-588. PubMedGoogle ScholarCrossref 24. Epstein HM, Fagman W, Bruce DC, et al: Intraocular pressure changes during anesthesia for electroconvulsive therapy. Anesth Analg. 1975;54:479-481. PubMedGoogle ScholarCrossref 25. Yudofsky SC, Rosenthal NE: ECT in a depressed patient with adult onset diabetes mellitus. Am J Psychiatry. 1980;137:100-101. PubMedGoogle ScholarCrossref 26. Regan AG, Aldrete JA: Prolonged apnea after administration of promazine hydrochloride following succinylcholine infusion. Anesth Analg. 1967;46:315-318. PubMedGoogle ScholarCrossref 27. Small JG, Kellams JJ, Milstein V, et al: Complications with electroconvulsive treatment combined with lithium. Biol Psychiatry. 1980;15:103-112. PubMedGoogle Scholar 28. Argov Z, Mastaglia FL: Disorders of neuromuscular transmission caused by drugs. N Engl J Med. 1979;301:409-413. PubMedGoogle ScholarCrossref 29. Gronert GA, Theye RA: Pathophysiology of hyperkalemia induced by succinylcholine. Anesthesiology. 1975;43:89-99. PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Electroconvulsive Therapy: Pretreatment Medical Evaluation

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340180137024
Publisher site
See Article on Publisher Site

Abstract

Abstract Electroconvulsive therapy (ECT) is finding increasing use in the therapy for psychiatric illness. This article reviews the physiological changes, potential complications, and drug interactions associated with ECT. The review provides the practitioner with guidelines for the evaluation and management of patients selected for ECT. Back to top Article Information Reprint requests to Division of General Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr Elliot). References 1. Frankel FH (ed): Report 14 on the American Psychiatric Association Task Force on convulsive therapy , in Electroconvulsive Therapy.. Washington, DC, American Psychiatric Association, 1978.Google Scholar 2. Fink M: Convulsive Therapy: Theory and Practice.. New York, Raven Press, 1979. 3. Brown ML, Huston PE, Hines HM, et al: Cardiovascular changes associated with electroconvulsive therapy in man. Arch Neurol. 1953;69:601-608. PubMedGoogle ScholarCrossref 4. Perrin GM: Cardiovascular and other physiologic changes accompanying EST. Acta Physiol Scand. 1961;36:10-45.Google Scholar 5. Bankhead AJ, Torrens JK, Harris TH: The anticipation and prevention of cardiac complications in electroconvulsive therapy. Am J Psychiatry. 1950;106:911-917. PubMedGoogle ScholarCrossref 6. Gravenstein JS, Anton AH, Wiener SM, et al: Catecholamine and cardiovascular response to electro-convulsion therapy in man. Br J Anaesth. 1965;37:833-839. PubMedGoogle ScholarCrossref 7. Anton AH, Uy DS, Redderson CL: Autonomic blockade and the cardiovascular and catecholamine response to electroshock. Anesth Analg. 1972;56:46-54. PubMedGoogle Scholar 8. Doba N, Beresford HR, Rets DJ: Changes in regional blood flow and cardiodynamics associated with electrically and chemically induced epilepsy in the cat. Brain Res. 1975;90:115-132. PubMedGoogle ScholarCrossref 9. Lewis WH Jr, Richardson DJ, Gahagan LH: Cardiovascular disturbances and their management in modified electrotherapy for psychiatric illness. N Engl J Med. 1955;252:1016-1020. PubMedGoogle ScholarCrossref 10. McKenna G, Engle RP Jr, Brooks H, et al: Cardiac arrhythmias during electroshock therapy: Significance, prevention, and treatment. Am J Psychiatry. 1978;127:172-175. PubMedGoogle Scholar 11. Pitts FN Jr, Desmarai GM, Steward W, et al: Induction of anesthesia with methohexital and thiopental in electroconvulsive therapy. N Engl J Med. 1965;273:353-360. PubMedGoogle ScholarCrossref 12. Green R, Woods A: Effects of modified ECT on the electrocardiogram. Br Med J. 1955;1:1503-1505. PubMedGoogle ScholarCrossref 13. Richardson J, Lewis WH, Gahagen LH, et al: Etiology and treatment of cardiac arrhythmias under anesthesia for electroconvulsive therapy. NY State J Med. 1959;57:881-886.Google Scholar 14. Weiner RD, Henschen GM, Dellasega M, et al: Propranolol treatment of ECT-related ventricular arrhythmias. Am J Psychiatry. 1979;136:1594-1595. PubMedGoogle ScholarCrossref 15. Bodley PO, Fenwick PBC: The effects of electroconvulsive therapy on patients with essential hypertension. Br J Psychiatry. 1966;112:1241-1249. PubMedGoogle ScholarCrossref 16. Foster MW Jr, Gayle RF Jr: Dangers in combining reserpine (Serpasil) with electroconvulsive therapy. JAMA. 1955;159:1520-1522. PubMedGoogle ScholarCrossref 17. Ciraulo D, Lind L, Salzman C, et al: Sodium nitroprusside treatment of ECT-induced blood pressure elevations. Am J Psychiatry. 1978;135:1105-1106. PubMedGoogle ScholarCrossref 18. Hussar AE, Pachter M: Myocardial infarction and fatal coronary insufficiency during electroconvulsive therapy. JAMA. 1968;204:146-149. PubMedGoogle ScholarCrossref 19. Goldman L, Caldera DL, Nussbaum SR, et al: Multifactorial index of cardiac risk in non-cardiac surgical procedures. N Engl J Med. 1977;297:845-850.Google ScholarCrossref 20. Youmans CR, Bourianoff G, Allensworth DC, et al: Cardiovascular alterations during electroconvulsive therapy in patients with cardiac pacemakers. South Med J. 1972;65:361-365. PubMedGoogle ScholarCrossref 21. Blitt CD, Kirschvink LJ: Electroconvulsive therapy with cardiac pacemakers. Anesthesiology. 1976;45:580.Google ScholarCrossref 22. Weinstein MR, Fischer A: Electroconvulsive treatment of a patient with artificial mitral and aortic valves. Am J Psychiatry. 1967;123:882-884. PubMedGoogle ScholarCrossref 23. Blumenthal IJ: Spontaneous seizures and related electroencephalographic findings following shock therapy. J Nerv Ment Dis. 1955;122:581-588. PubMedGoogle ScholarCrossref 24. Epstein HM, Fagman W, Bruce DC, et al: Intraocular pressure changes during anesthesia for electroconvulsive therapy. Anesth Analg. 1975;54:479-481. PubMedGoogle ScholarCrossref 25. Yudofsky SC, Rosenthal NE: ECT in a depressed patient with adult onset diabetes mellitus. Am J Psychiatry. 1980;137:100-101. PubMedGoogle ScholarCrossref 26. Regan AG, Aldrete JA: Prolonged apnea after administration of promazine hydrochloride following succinylcholine infusion. Anesth Analg. 1967;46:315-318. PubMedGoogle ScholarCrossref 27. Small JG, Kellams JJ, Milstein V, et al: Complications with electroconvulsive treatment combined with lithium. Biol Psychiatry. 1980;15:103-112. PubMedGoogle Scholar 28. Argov Z, Mastaglia FL: Disorders of neuromuscular transmission caused by drugs. N Engl J Med. 1979;301:409-413. PubMedGoogle ScholarCrossref 29. Gronert GA, Theye RA: Pathophysiology of hyperkalemia induced by succinylcholine. Anesthesiology. 1975;43:89-99. PubMedGoogle ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1982

Keywords: electroconvulsive therapy,mental disorders,drug interactions

References