PittsburghV1, PascalFrancis, Corpus, bibRecord, 003137

Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

Identifieur interne : 003137 ( PascalFrancis/Corpus ); précédent : 003136; suivant : 003138

Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy

Auteurs : Joan Prudic ; Roger F. Haskett ; W. Vaughn Mccall ; Keith Isenberg ; Thomas Cooper ; Peter B. Rosenquist ; Benoit H. Mulsant ; Harold A. Sackeim

Source :

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

RBID : Francis:13-0113314

Descripteurs français

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

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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C01	`01`		`ENG`	@0 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.
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Format Inist (serveur)

NO :	FRANCIS 13-0113314 INIST
ET :	Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy
AU :	PRUDIC (Joan); HASKETT (Roger F.); VAUGHN MCCALL (W.); ISENBERG (Keith); COOPER (Thomas); ROSENQUIST (Peter B.); MULSANT (Benoit H.); SACKEIM (Harold A.)
AF :	New York State Psychiatric Institute and Department of Psychiatry, Columbia University/New York, NY/Etats-Unis (1 aut., 5 aut., 8 aut.); Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh/Pittsburgh, PA/Etats-Unis (2 aut., 7 aut.); Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine/Winston-Salem, NC/Etats-Unis (3 aut., 6 aut.); Department of Psychiatry, Washington University/St. Louis, MO/Etats-Unis (4 aut.); Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto/Toronto, Ontario/Canada (7 aut.)
DT :	Publication en série; Niveau analytique
SO :	The Journal of ECT; ISSN 1095-0680; Etats-Unis; Da. 2013; Vol. 29; No. 1; Pp. 3-12; Bibl. 37 ref.
LA :	Anglais
EA :	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.
CC :	770D09A; 770E02
FD :	Stratégie; Prévention; Santé publique; Récidive; Electroconvulsivothérapie; Antidépresseur; Nortriptyline; Venlafaxine; Lithium; Normothymique; Psychotrope
FG :	Traitement; Composé tricyclique; Inhibiteur recapture; Noradrénaline; Phénéthylamine dérivé; Sérotonine; Catécholamine; Neurotransmetteur
ED :	Strategy; Prevention; Public health; Relapse; Electroconvulsive therapy; Antidepressant agent; Nortriptyline; Venlafaxine; Lithium; Mood stabilizer; Psychotropic
EG :	Treatment; Tricyclic compound; Reuptake inhibitor; Norepinephrine; Phénéthylamine derivatives; Serotonin; Catecholamine; Neurotransmitter
SD :	Estrategia; Prevención; Salud pública; Recaida; Terapia electroconvulsiva; Antidepresor; Nortriptilina; Venlafaxina; Litio; Estabilizador humor; Psicotropo
LO :	INIST-20616.354000502411820020
ID :	13-0113314

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Francis:13-0113314

Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antidepressant agent</term>
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<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>
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<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>
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<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1095-0680</s0>
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<fA06><s2>1</s2>
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<fA08 i1="01" i2="1" l="ENG"><s1>Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy</s1>
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<fA11 i1="01" i2="1"><s1>PRUDIC (Joan)</s1>
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<fA11 i1="02" i2="1"><s1>HASKETT (Roger F.)</s1>
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<fA11 i1="03" i2="1"><s1>VAUGHN MCCALL (W.)</s1>
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<fA11 i1="04" i2="1"><s1>ISENBERG (Keith)</s1>
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<fA11 i1="05" i2="1"><s1>COOPER (Thomas)</s1>
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<fA11 i1="06" i2="1"><s1>ROSENQUIST (Peter B.)</s1>
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<fA11 i1="07" i2="1"><s1>MULSANT (Benoit H.)</s1>
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<fA11 i1="08" i2="1"><s1>SACKEIM (Harold A.)</s1>
</fA11>
<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>
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<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>
</fA14>
<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>
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<fA14 i1="04"><s1>Department of Psychiatry, Washington University</s1>
<s2>St. Louis, MO</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
</fA14>
<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>
</fA14>
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<fC01 i1="01" l="ENG"><s0>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.</s0>
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<s5>08</s5>
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<fC03 i1="08" i2="X" l="ENG"><s0>Venlafaxine</s0>
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<s2>FR</s2>
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<server><NO>FRANCIS 13-0113314 INIST</NO>
<ET>Pharmacological Strategies in the Prevention of Relapse After Electroconvulsive Therapy</ET>
<AU>PRUDIC (Joan); HASKETT (Roger F.); VAUGHN MCCALL (W.); ISENBERG (Keith); COOPER (Thomas); ROSENQUIST (Peter B.); MULSANT (Benoit H.); SACKEIM (Harold A.)</AU>
<AF>New York State Psychiatric Institute and Department of Psychiatry, Columbia University/New York, NY/Etats-Unis (1 aut., 5 aut., 8 aut.); Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh/Pittsburgh, PA/Etats-Unis (2 aut., 7 aut.); Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine/Winston-Salem, NC/Etats-Unis (3 aut., 6 aut.); Department of Psychiatry, Washington University/St. Louis, MO/Etats-Unis (4 aut.); Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto/Toronto, Ontario/Canada (7 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>The Journal of ECT; ISSN 1095-0680; Etats-Unis; Da. 2013; Vol. 29; No. 1; Pp. 3-12; Bibl. 37 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>770D09A; 770E02</CC>
<FD>Stratégie; Prévention; Santé publique; Récidive; Electroconvulsivothérapie; Antidépresseur; Nortriptyline; Venlafaxine; Lithium; Normothymique; Psychotrope</FD>
<FG>Traitement; Composé tricyclique; Inhibiteur recapture; Noradrénaline; Phénéthylamine dérivé; Sérotonine; Catécholamine; Neurotransmetteur</FG>
<ED>Strategy; Prevention; Public health; Relapse; Electroconvulsive therapy; Antidepressant agent; Nortriptyline; Venlafaxine; Lithium; Mood stabilizer; Psychotropic</ED>
<EG>Treatment; Tricyclic compound; Reuptake inhibitor; Norepinephrine; Phénéthylamine derivatives; Serotonin; Catecholamine; Neurotransmitter</EG>
<SD>Estrategia; Prevención; Salud pública; Recaida; Terapia electroconvulsiva; Antidepresor; Nortriptilina; Venlafaxina; Litio; Estabilizador humor; Psicotropo</SD>
<LO>INIST-20616.354000502411820020</LO>
<ID>13-0113314</ID>
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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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