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Titolo:
Electroconvulsive thera in the era of modern psychopharmacology
Autore:
McCall, WV;
Indirizzi:
Wake Forest Univ, Sch Med, Dept Psychiat & Behav Med, Winston Salem, NC 27157 USA Wake Forest Univ Winston Salem NC USA 27157 , Winston Salem, NC 27157 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY
fascicolo: 3, volume: 4, anno: 2001,
pagine: 315 - 324
SICI:
1461-1457(200109)4:3<315:ETITEO>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
TREATMENT-RESISTANT SCHIZOPHRENIA; NEUROLEPTIC MALIGNANT SYNDROME; OBSESSIVE-COMPULSIVE DISORDER; COMBINED ECT; ELECTRODE PLACEMENT; PARKINSONS-DISEASE; MAJOR DEPRESSION; DOUBLE-BLIND; AMOBARBITAL INTERVIEW; STIMULUS-INTENSITY;
Keywords:
catalonia; electroconvulsive therapy; major depression; neuroleptic malignant syndrome; Parkinson's disease; relapse; treatment resistance;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
88
Recensione:
Indirizzi per estratti:
Indirizzo: McCall, WV Wake Forest Univ, Sch Med, Dept Psychiat & Behav Med, Med Ctr Blvd, Winston Salem, NC 27157 USA Wake Forest Univ Med Ctr Blvd Winston Salem NC USA 27157 57 USA
Citazione:
W.V. McCall, "Electroconvulsive thera in the era of modern psychopharmacology", IN J NEUROP, 4(3), 2001, pp. 315-324

Abstract

Fifty years of advances in the pharmacotherapy of major depression (MDE), mania, schizophrenia, and other severe and persistent psychiatric disordershave neither made ECT obsolete nor unnecessary. However, advances in pharmacotherapy have radically changed the practice of ECT. ECT is rarely a first-line treatment of mental disorder, unless the clinical situation is desperate. Otherwise, ECT is most often offered to persons who have failed to respond to pharmacotherapy, thus defining a relatively treatment-refractory population for ECT. The physician who refers patients for ECT, as well as the ECT provider, must be able to judge at what point a patient is deemed 'medication resistant', implying expertise in pharmacotherapy for both the referring physician and the ECT provider. Authoritative sources from 20 years ago quoted antidepressant response rates greater than or equal to 90% for ECT, but the antidepressant response rate in medication-resistant MDE may beonly 60%. Improvements in the safety of ECT have resulted in the referral of large numbers of older persons for ECT. High relapse rates after ECT areperhaps the biggest problem presently facing patients and providers. High relapse rates are not surprising given that (i) most patients are medication resistant, and (ii) ECT is usually withdrawn at the moment it becomes effective. Although continuation/maintenance ECT is an option in preventing relapse, it may not be a practical solution for persons still in their productive years, and it is resource-intensive. Still, continuation/maintenance ECT is the only method to prevent relapse and recurrence of severe psychiatric disorder for some persons.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 19:05:12