James Luccarelli1, Thomas H McCoy2, Stephen J Seiner3, Michael E Henry2. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jluccarelli@partners.org. 2. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 3. Department of Psychiatry, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: Seizure duration has long been measured as a potential marker of ECT treatment efficacy, with concern that short seizures may be clinically ineffective. Relatively small studies have documented a trend towards shorter seizures during acute course ECT, but data from large cohorts would help provide normative data on seizure duration changes during treatment. OBJECTIVE: This study analyzes the effects of age, sex, ECT dose, and treatment number on the duration of electrographic seizures during acute course ECT in a large single-center cohort. METHODS: A single-center retrospective chart review was conducted of adult patients receiving a first course of ECT from 2000 to 2017 at a large freestanding psychiatric hospital. RESULTS: 3648 patients met inclusion criteria, receiving 32,879 acute course ECT treatments. There was a shortening of mean ECT seizure duration over the acute course, with the greatest decrease in duration over the first 3 treatments but continuing decreases over the entire acute course. Older age, higher ECT dose, and increasing treatment number were all associated with shorter seizures, while sex was not significantly associated. Increasing treatment dose was associated with shorter seizures relative to no dose increase, with those patients receiving the highest cumulative doses also having the shortest cumulative seizure time. CONCLUSIONS: Among patients undergoing acute-course ECT treatment, seizure duration decreased over the treatment course, and increases in applied electrical charge were associated with shorter seizures.
BACKGROUND: Seizure duration has long been measured as a potential marker of ECT treatment efficacy, with concern that short seizures may be clinically ineffective. Relatively small studies have documented a trend towards shorter seizures during acute course ECT, but data from large cohorts would help provide normative data on seizure duration changes during treatment. OBJECTIVE: This study analyzes the effects of age, sex, ECT dose, and treatment number on the duration of electrographic seizures during acute course ECT in a large single-center cohort. METHODS: A single-center retrospective chart review was conducted of adult patients receiving a first course of ECT from 2000 to 2017 at a large freestanding psychiatric hospital. RESULTS: 3648 patients met inclusion criteria, receiving 32,879 acute course ECT treatments. There was a shortening of mean ECT seizure duration over the acute course, with the greatest decrease in duration over the first 3 treatments but continuing decreases over the entire acute course. Older age, higher ECT dose, and increasing treatment number were all associated with shorter seizures, while sex was not significantly associated. Increasing treatment dose was associated with shorter seizures relative to no dose increase, with those patients receiving the highest cumulative doses also having the shortest cumulative seizure time. CONCLUSIONS: Among patients undergoing acute-course ECT treatment, seizure duration decreased over the treatment course, and increases in applied electrical charge were associated with shorter seizures.
Authors: Suna Su Aksay; Jan Malte Bumb; Christoph Janke; Carolin Hoyer; Laura Kranaster; Alexander Sartorius Journal: J ECT Date: 2014-12 Impact factor: 3.635
Authors: U Kessler; J Bjorke-Bertheussen; E Søreide; P A Hunderi; L Bache-Mathiesen; K J Oedegaard; A Sartorius; H Schoeyen Journal: Br J Anaesth Date: 2018-08-16 Impact factor: 9.166
Authors: Keith E Isenberg; Stephen Dinwiddie; A Chris Heath; Victoria Osborne; Micah Tepper; Michael Jarvis; Edward L Spitznagel; Charles F Zorumski; Carol S North Journal: Ann Clin Psychiatry Date: 2016-05 Impact factor: 1.567
Authors: Laila Chomrikh; Mustafa Ahmadi; T Martijn Kuijper; Joris J B van der Vlugt; Seppe J H A Koopman Journal: BMC Anesthesiol Date: 2022-07-05 Impact factor: 2.376
Authors: James Luccarelli; Thomas H McCoy; Ryan J Horvath; Stephen J Seiner; Michael E Henry Journal: Brain Stimul Date: 2021-07-20 Impact factor: 8.955