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. 2019 Sep;16(9):704-712.
doi: 10.30773/pi.2019.06.20.2. Epub 2019 Aug 21.

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Seong Hoon Jeong  1 , Tak Youn  2   3 , Younsuk Lee  4 , Jin Hyeok Jang  2 , Young Wook Jeong  2 , Yong Sik Kim  2   3 , In Won Chung  2   3
Affiliations

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Seong Hoon Jeong et al. Psychiatry Investig. 2019 Sep.

Abstract

Objective: The present study aimed to report the initial seizure threshold (IST) of a brief-pulse bilateral electroconvulsive therapy (BP-BL ECT) in Korean patients with schizophrenia/schizoaffective disorder and to identify IST predictors.

Methods: Among 67 patients who received ECT and diagnosed with schizophrenia/schizoaffective disorder based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, we included 56 patients who received 1-millisecond BP-BL ECT after anesthesia with sodium thiopental between March 2012 and June 2018. Demographic and clinical information was gathered from electronic medical records, and a multiple regression analysis was conducted to identify predictors of the IST.

Results: The mean age of the patients was 36.9±12.0 years and 30 (53.6%) patients were male. The mean and median IST were 105.9±54.5 and 96 millicoulombs (mC), respectively. The IST was predicted by age, gender, and dose (mg/kg) of sodium thiopental. Other physical and clinical variables were not associated with the IST.

Conclusion: The present study demonstrated that the IST of 1-ms BP-BL ECT following sodium thiopental anesthesia in Korean patients was comparable to those reported in previous literature. The IST was associated with age, gender, and dose of sodium thiopental.

Keywords: Bilateral electrode placement; Brief-pulse width; Electroconvulsive therapy; Initial seizure threshold; Schizoaffective disorder; Schizophrenia.

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Conflict of interest statement

Dr. Kim YS received grants, research support and honoraria from Janssen, Otsuka, and Dainippon Sumitomo. Dr. Chung IW received research and educational grants from Janssen, Otsuka, Hanmi, Mecta, and Whanin. Dr. Youn T received research and educational grants from Otsuka, Eisai, Hanmi, Lundbeck, and Mecta. The others have nothing to declare.

Figures

Figure 1.
Figure 1.
The distibution of IST after 1-millisecond pulse width BP-BL ECT. The IST values were estimated by empirical titration methods according to a predefined protocol. The subjects were 56 patients with schizophrenia and schizophreniform disorder. ECT was administered after anesthesia with sodium thiopental (gray dots are the actual cases and the thick black line is the estimated kernel density). IST: initial seizure threshold, BP-BL: brief-pulse bilateral, ECT: electrovulsive therapy.
Figure 2.
Figure 2.
Relationships between IST and age, gender, and dose of sodium thiopental in patients who underwent BP-BL ECT after anesthesia with sodium thiopental. The overlaid lines represent the linear regression lines through respective subsets of study subjects. A: Relationship between IST and age stratified by gender and dose (mg/kg) of sodium thiopental using an arbitrary categorization of dose into three non-overlapping ranges with equal numbers of patients. B: Relationship between IST and dose (mg/kg) of sodium thiopental stratified by gender and age using an arbitrary categorization of age into three non-overlapping ranges with equal numbers of patients. IST: initial seizure threshold, BP-BL: brief-pulse bilateral, ECT: electrovulsive therapy.
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References

    1. Kellner CH, Greenberg RM, Murrough JW, Bryson EO, Briggs MC, Pasculli RM. ECT in treatment-resistant depression. Am J Psychiatry. 2012;169:1238–1244. - PubMed
    1. Pompili M, Lester D, Dominici G, Longo L, Marconi G, Forte A, et al. Indications for electroconvulsive treatment in schizophrenia: a systematic review. Schizophr Res. 2013;146:1–9. - PubMed
    1. Sackeim H, Decina P, Prohovnik I, Malitz S. Seizure threshold in electroconvulsive therapy. Effects of sex, age, electrode placement, and number of treatments. Arch Gen Psychiatry. 1987;44:355–360. - PubMed
    1. McCall WV, Reboussin DM, Weiner RD, Sackeim HA. Titrated moderately suprathreshold vs fixed high-dose right unilateral electroconvulsive therapy: acute antidepressant and cognitive effects. Arch Gen Psychiatry. 2000;57:438–444. - PubMed
    1. Loo CK, Schweitzer I, Pratt C. Recent advances in optimizing electroconvulsive therapy. Aust N Z J Psychiatry. 2006;40:632–638. - PubMed

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