PittsburghV1, Canada, Analysis, bibRecord, 000415

Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

Identifieur interne : 000415 ( Canada/Analysis ); précédent : 000414; suivant : 000416

Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

Auteurs : Joan Prudic [États-Unis] ; Roger F. Haskett [États-Unis] ; W. Vaughn Mccall [États-Unis] ; Keith Isenberg [États-Unis] ; Thomas Cooper [États-Unis] ; Peter B. Rosenquist [États-Unis] ; Benoit H. Mulsant [États-Unis, Canada] ; Harold A. Sackeim [États-Unis]

Source :

The Journal of ECT [ 1095-0680 ] ; 2013.

RBID : Pascal:13-0113314

Descripteurs français

Pascal (Inist)
- Stratégie, Prévention, Santé publique, Récidive, Electroconvulsivothérapie, Antidépresseur, Nortriptyline, Venlafaxine, Lithium, Normothymique, Psychotrope.
Wicri :
- topic : Santé publique.

English descriptors

KwdEn :
- Antidepressant agent, Electroconvulsive therapy, Lithium, Mood stabilizer, Nortriptyline, Prevention, Psychotropic, Public health, Relapse, Strategy, Venlafaxine.

Abstract

Objective: To determine whether starting antidepressant medication at the start of electroconvulsive therapy (ECT) reduces post-ECT relapse and to determine whether continuation pharmacotherapy with nortriptyline (NT) and lithium (Li) differs in efficacy or adverse effects from continuation pharmacotherapy with venlafaxine (VEN) and Li. Methods: During an acute ECT phase, 319 patients were randomized to treatment with moderate dosage bilateral ECT or high-dosage right unilateral ECT. They were also randomized to concurrent treatment with placebo, NT, or VEN. Of 181 patients to meet post-ECT remission criteria, 122 (67.4%) participated in a second continuation pharmacotherapy phase. Patients earlier randomized to NT or VEN continued on the antidepressant, whereas patients earlier randomized to placebo were now randomized to NT or VEN. Lithium was added for all patients who were followed until relapse or 6 months. Results: Starting an antidepressant medication at the beginning of the ECT course did not affect the rate or timing of relapse relative to starting pharmacotherapy after ECT completion. The combination of NT and Li did not differ from VEN and Li in any relapse or adverse effect measure. Older age was strongly associated with lower relapse risk, whereas the type of ECT administered in the acute phase and medication resistance were not predictive. Across sites, 50% of the patients relapsed, 33.6% continued in remission 6 months after ECT, and 16.4% dropped out. Conclusions: Starting an antidepressant medication during ECT does not affect relapse, and there are concerns about administering Li during an acute ECT course. Nortriptyline and VEN were equally effective in prolonging remission, although relapse rates after ECT are substantial despite intensive pharmacology. As opposed to the usual abrupt cessation of ECT, the impact of an ECT taper should be evaluated.

Affiliations:

Links to Exploration step

Pascal:13-0113314

Le document en format XML

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<affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto</s1>
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<author><name sortKey="Sackeim, Harold A" sort="Sackeim, Harold A" uniqKey="Sackeim H" first="Harold A." last="Sackeim">Harold A. Sackeim</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy</title>
<author><name sortKey="Prudic, Joan" sort="Prudic, Joan" uniqKey="Prudic J" first="Joan" last="Prudic">Joan Prudic</name>
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<author><name sortKey="Haskett, Roger F" sort="Haskett, Roger F" uniqKey="Haskett R" first="Roger F." last="Haskett">Roger F. Haskett</name>
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<region type="state">Pennsylvanie</region>
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</affiliation>
</author>
<author><name sortKey="Vaughn Mccall, W" sort="Vaughn Mccall, W" uniqKey="Vaughn Mccall W" first="W." last="Vaughn Mccall">W. Vaughn Mccall</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine</s1>
<s2>Winston-Salem, NC</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Winston-Salem, NC</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Isenberg, Keith" sort="Isenberg, Keith" uniqKey="Isenberg K" first="Keith" last="Isenberg">Keith Isenberg</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Psychiatry, Washington University</s1>
<s2>St. Louis, MO</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>St. Louis, MO</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Cooper, Thomas" sort="Cooper, Thomas" uniqKey="Cooper T" first="Thomas" last="Cooper">Thomas Cooper</name>
<affiliation wicri:level="4"><inist:fA14 i1="01"><s1>New York State Psychiatric Institute and Department of Psychiatry, Columbia University</s1>
<s2>New York, NY</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>8 aut.</sZ>
</inist:fA14>
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<region type="state">État de New York</region>
</placeName>
<orgName type="university">Université Columbia</orgName>
</affiliation>
</author>
<author><name sortKey="Rosenquist, Peter B" sort="Rosenquist, Peter B" uniqKey="Rosenquist P" first="Peter B." last="Rosenquist">Peter B. Rosenquist</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine</s1>
<s2>Winston-Salem, NC</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Winston-Salem, NC</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name>
<affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh</s1>
<s2>Pittsburgh, PA</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><settlement type="city">Pittsburgh</settlement>
<region type="state">Pennsylvanie</region>
</placeName>
<orgName type="university">Université de Pittsburgh</orgName>
</affiliation>
<affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto</s1>
<s2>Toronto, Ontario</s2>
<s3>CAN</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>Canada</country>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
<orgName type="university">Université de Toronto</orgName>
</affiliation>
</author>
<author><name sortKey="Sackeim, Harold A" sort="Sackeim, Harold A" uniqKey="Sackeim H" first="Harold A." last="Sackeim">Harold A. Sackeim</name>
<affiliation wicri:level="4"><inist:fA14 i1="01"><s1>New York State Psychiatric Institute and Department of Psychiatry, Columbia University</s1>
<s2>New York, NY</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><settlement type="city">New York</settlement>
<region type="state">État de New York</region>
</placeName>
<orgName type="university">Université Columbia</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">The Journal of ECT</title>
<title level="j" type="abbreviated">J. ECT</title>
<idno type="ISSN">1095-0680</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">The Journal of ECT</title>
<title level="j" type="abbreviated">J. ECT</title>
<idno type="ISSN">1095-0680</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antidepressant agent</term>
<term>Electroconvulsive therapy</term>
<term>Lithium</term>
<term>Mood stabilizer</term>
<term>Nortriptyline</term>
<term>Prevention</term>
<term>Psychotropic</term>
<term>Public health</term>
<term>Relapse</term>
<term>Strategy</term>
<term>Venlafaxine</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Stratégie</term>
<term>Prévention</term>
<term>Santé publique</term>
<term>Récidive</term>
<term>Electroconvulsivothérapie</term>
<term>Antidépresseur</term>
<term>Nortriptyline</term>
<term>Venlafaxine</term>
<term>Lithium</term>
<term>Normothymique</term>
<term>Psychotrope</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Objective: To determine whether starting antidepressant medication at the start of electroconvulsive therapy (ECT) reduces post-ECT relapse and to determine whether continuation pharmacotherapy with nortriptyline (NT) and lithium (Li) differs in efficacy or adverse effects from continuation pharmacotherapy with venlafaxine (VEN) and Li. Methods: During an acute ECT phase, 319 patients were randomized to treatment with moderate dosage bilateral ECT or high-dosage right unilateral ECT. They were also randomized to concurrent treatment with placebo, NT, or VEN. Of 181 patients to meet post-ECT remission criteria, 122 (67.4%) participated in a second continuation pharmacotherapy phase. Patients earlier randomized to NT or VEN continued on the antidepressant, whereas patients earlier randomized to placebo were now randomized to NT or VEN. Lithium was added for all patients who were followed until relapse or 6 months. Results: Starting an antidepressant medication at the beginning of the ECT course did not affect the rate or timing of relapse relative to starting pharmacotherapy after ECT completion. The combination of NT and Li did not differ from VEN and Li in any relapse or adverse effect measure. Older age was strongly associated with lower relapse risk, whereas the type of ECT administered in the acute phase and medication resistance were not predictive. Across sites, 50% of the patients relapsed, 33.6% continued in remission 6 months after ECT, and 16.4% dropped out. Conclusions: Starting an antidepressant medication during ECT does not affect relapse, and there are concerns about administering Li during an acute ECT course. Nortriptyline and VEN were equally effective in prolonging remission, although relapse rates after ECT are substantial despite intensive pharmacology. As opposed to the usual abrupt cessation of ECT, the impact of an ECT taper should be evaluated.</div>
</front>
</TEI>
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<li>États-Unis</li>
</country>
<region><li>Ontario</li>
<li>Pennsylvanie</li>
<li>État de New York</li>
</region>
<settlement><li>New York</li>
<li>Pittsburgh</li>
<li>Toronto</li>
</settlement>
<orgName><li>Université Columbia</li>
<li>Université de Pittsburgh</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="État de New York"><name sortKey="Prudic, Joan" sort="Prudic, Joan" uniqKey="Prudic J" first="Joan" last="Prudic">Joan Prudic</name>
</region>
<name sortKey="Cooper, Thomas" sort="Cooper, Thomas" uniqKey="Cooper T" first="Thomas" last="Cooper">Thomas Cooper</name>
<name sortKey="Haskett, Roger F" sort="Haskett, Roger F" uniqKey="Haskett R" first="Roger F." last="Haskett">Roger F. Haskett</name>
<name sortKey="Isenberg, Keith" sort="Isenberg, Keith" uniqKey="Isenberg K" first="Keith" last="Isenberg">Keith Isenberg</name>
<name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name>
<name sortKey="Rosenquist, Peter B" sort="Rosenquist, Peter B" uniqKey="Rosenquist P" first="Peter B." last="Rosenquist">Peter B. Rosenquist</name>
<name sortKey="Sackeim, Harold A" sort="Sackeim, Harold A" uniqKey="Sackeim H" first="Harold A." last="Sackeim">Harold A. Sackeim</name>
<name sortKey="Vaughn Mccall, W" sort="Vaughn Mccall, W" uniqKey="Vaughn Mccall W" first="W." last="Vaughn Mccall">W. Vaughn Mccall</name>
</country>
<country name="Canada"><region name="Ontario"><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name>
</region>
</country>
</tree>
</affiliations>
</record>

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Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

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Descripteurs français

English descriptors

Abstract

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Links to Exploration step

Le document en format XML

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