Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

minimizing ECT induced memory loss

Posted by katekite on August 1, 2002, at 21:57:00

This is just a series of abstracts regarding minimizing memory loss with ECT. My interpretation is at the top.

The newer strategies to lower memory loss and cognitive problems seem to be: avoiding blood pressure fluctuation during the treatments, consuming caffeine before each treatment (or phenylephrine like in daytime flu medicine), keeping cortisol as low as possible (get it checked before to make sure it is not high), fewer treatments per week (2 not 3, total number not as important). TRH (thyroid stimulation) also may minimize memory loss. In a study, that I did not include, in rats piracetam has protective effects but a different study in people did not find this.

Keep in mind these reports all specifically look for helping memory, not necessarily also maximizing anti-depressive effect or anything else. They are small studies so they could be wrong. If you are considering ECT be aware that some memory problem can be found in almost everyone though it often is negligible: it is less risky as far as memory and cognition goes in younger people and those who do not have heart disease. Some relevant percentage of people unfortunately have life altering cognitive or memory loss so the risk is not to be ignored (though the possible benefits may outweigh the risks). It can be extremely effective for depression relief and is regaining some limited popularity when drugs have repeatedly failed. One fairly small study I did not include showed no difference in suicide rate whether or not a person had been given ECT, so some aspects of efficacy are controversial.

If you might consider taking caffeine or phenylephrine be sure to talk it over with the docs. Be sure also to mention any herbal supplements or vitamins even if you have taken them for years. Avoid licorice before treatments.


Convuls Ther 1993;9(2):95-100 Related Articles, Books, LinkOut

Caffeine Pretreatment Enhances Clinical Efficacy and Reduces Cognitive Effects of Electroconvulsive Therapy.

Calev A, Fink M, Petrides G, Francis A, Fochtmann L.

Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, New York, USA.

In an open clinical trial, depressed patients received age-dosed, brief-pulse electroconvulsive therapy (ECT) either with or without 500 mg i.v. caffeine sodium benzoate before each treatment. Caffeine-pretreated patients required fewer ECT treatments, and after three to four treatments, their Hamilton Depression Scale (HDS) scores were significantly lower. At the end of the ECT course, both groups reached the same reduction in HDS scores. Of five memory tests, one showed better performance at the end of the ECT course for the caffeine-pretreated compared with the non-caffeine-pretreated patients. The results argue that caffeine-modified ECT differs from unmodified ECT in speed of response and the effects on cognitive tests.


Convuls Ther 1993;9(1):14-22 Related Articles, Books, LinkOut

Blood Pressure, Memory, and Electroconvulsive Therapy.

Zervas IM, Calev A, Jandorf L, Fink M.

Department of Psychiatry and Behavioral Sciences, State University of New York, Stony Brook, New York, USA.

Blood pressure changes recorded during electroconvulsive therapy (ECT) in 23 psychiatric in-patients with major depressive disorders correlated with and predicted the degree of anterograde memory changes measured 48-72 h after ECT. The Randt memory test was the principal measure of memory change. A subgroup of older patients with cardiovascular illness received trimethaphan, a ganglionic blocker that impedes a hypertensive surge during the treatment. They did not differ in memory function from a younger subgroup that did not receive trimethaphan. Control of the hypertensive response in the older age group counterbalanced the additional memory dysfunction that was anticipated as a result of advanced age and cardiovascular pathology.


Biol Psychiatry 2001 Sep 1;50(5):331-6 Related Articles, Books, LinkOut

Cortisol levels predict cognitive impairment induced by electroconvulsive therapy.

Neylan TC, Canick JD, Hall SE, Reus VI, Sapolsky RM, Wolkowitz OM.

Department of Psychiatry, University of California, San Francisco, CA 94121, USA.

BACKGROUND: Elevated glucocorticoids may increase the vulnerability of the brain to the adverse effects of repeated seizures. This study tested the hypothesis that higher ambient cortisol levels would predict increased cognitive impairment in depressed patients subsequent to receiving electroconvulsive therapy (ECT) for major depression. METHODS: Sixteen subjects provided three samples of saliva the day before receiving unilateral nondominant ECT. Measures of mood, global cognitive functioning, attention, executive function, verbal and visuospatial memory, and visuospatial processing speed were obtained 1 day before the first ECT and 1 day after the sixth ECT treatment. The relationship between basal salivary cortisol obtained before the first ECT treatment and the change score of each cognitive measure after the sixth ECT treatment was examined and tested with Pearson correlation coefficients. RESULTS: Electroconvulsive therapy treatments delivered over 2 weeks resulted in a significant improvement in mood and a decline in most measures of cognitive performance. Elevated basal cortisol was associated with a greater decline in performance of executive function, visuospatial processing speed, and verbal memory. CONCLUSIONS: Although this study is limited by the small number of subjects and the high number of comparisons, all significant correlations were consistent with the hypothesis that elevated cortisol predicts a greater degree of ECT-induced cognitive impairment.


1: J ECT 2000 Jun;16(2):97-109 Related Articles, Books, LinkOut

Balancing speed of response to ECT in major depression and adverse cognitive effects: role of treatment schedule.

Shapira B, Tubi N, Lerer B.

Depression Unit, Herzog Hospital, Jerusalem, Israel.

Schedule of administration (number of ECT per week and total number of treatments in the course) is one of a number of factors that may significantly influence the degree of cognitive impairment induced by ECT. We examined the effect of twice (ECT x 2) versus three times weekly (ECT x 3) bilateral ECT on cognitive function, particularly memory, in patients with major depression. Two studies were conducted, both double blind and controlled by the administration of simulated ECT (anesthesia and muscle relaxant only with no electrical stimulation). The results of these studies showed that the antidepressant effect of the two schedules, when assessed at the end of the ECT course, was equal. Speed of response was significantly greater with ECT x 3 but this schedule induced more severe memory impairment, even when the number of ECT in the series was not significantly different between the two groups. These findings are in general accordance with other studies that were similar in design although not as rigorously controlled. They support the conclusion that ECT x 2 is the more appropriate schedule for regular clinical practice unless speed of response is an overriding concern. In an era when patients administered ECT tend to be older and are more likely to manifest cognitive impairment for other reasons, choice of schedule is of particular relevance along with other factors such as electrode placement and stimulus intensity that influence ECT-induced cognitive impairment.


J ECT 1998 Dec;14(4):236-40 Related Articles, Books, LinkOut

Effects of TRH administration on orientation time and recall after ECT.

Zervas IM, Pehlivanidis AA, Papakostas YG, Markianos M, Papadimitriou GN, Stefanis CN.

Department of Psychiatry, Athens University Medical School, Eginition Hospital, Greece.

We investigated the effect of thyrotropin-releasing hormone (TRH) on orientation time and recall, in nine depressed female inpatients undergoing electroconvulsive therapy (ECT). In a balanced order crossover design, an intravenous bolus of 0.4 mg TRH or placebo was administered 20 min before ECT in the first two sessions. Orientation time and retrograde and anterograde components of the memory dysfunction, immediately and 24 h later, were assessed. Administration of TRH did not influence orientation time, word recall, or immediate short story recall compared with placebo. We did find, however, an improvement in the number of short story items recalled after 24 h when patients were given TRH compared with placebo. This indicates that TRH may have a protective role against the specific negative effect of ECT on delayed recall.




Post a new follow-up

Your message only Include above post

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.


Start a new thread

Google www
Search options and examples
[amazon] for

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:katekite thread:114868