RESUMO
There is limited literature addressing the safety of administering electroconvulsive therapy (ECT) to patients concomitantly receiving bupropion monotherapy or in combination with other drugs that may alter the seizure threshold. We describe a prolonged seizure occurring during the first treatment of a course of ECT in an adult patient receiving long-term bupropion therapy, lithium, and venlafaxine.
Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Antimaníacos/efeitos adversos , Bupropiona/efeitos adversos , Cicloexanóis/efeitos adversos , Eletroconvulsoterapia/efeitos adversos , Carbonato de Lítio/efeitos adversos , Convulsões/etiologia , Antidepressivos de Segunda Geração/uso terapêutico , Antimaníacos/uso terapêutico , Bupropiona/uso terapêutico , Cicloexanóis/uso terapêutico , Humanos , Carbonato de Lítio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Convulsões/fisiopatologia , Fatores de Tempo , Cloridrato de VenlafaxinaRESUMO
OBJECTIVE: To determine the effect of subcortical white and gray matter lesions on ECT outcome. METHOD: 41 geriatric psychiatric inpatients underwent an MRI scan during their ECT work-up. Periventricular, deep white matter, and subcortical gray matter hyperintensities were graded. The associations of low versus high hyperintensity ratings and symptom scores, Clinical Global Impression severity (CGS) ratings, Montgomery-Asberg Depression Scale score, and number of treatments were examined using t-tests and repeated measures ANOVA. RESULTS: Patients with more severe subcortical gray hyperintensities (SCG) had significantly less improvement as measured by CGS ratings. CONCLUSIONS: SCG severity may limit the improvement of patients receiving ECT. Further studies are needed to examine differences based on electrode placement and to determine whether patients with severe SCG may require more ECT treatments in an index course.