PMID- 9231319
OWN - NLM
STAT- MEDLINE
DCOM- 19970812
LR  - 20220310
IS  - 1044-5463 (Print)
IS  - 1044-5463 (Linking)
VI  - 6
IP  - 4
DP  - 1996 Winter
TI  - Electroconvulsive treatment in adolescents with pharmacotherapy-refractory 
      depression.
PG  - 259-71
AB  - The effectiveness and safety of ECT in pharmacotherapy-refractory depression was 
      examined in 11 hospitalized adolescents (ages 16.3 +/- 1.7 years, 10 females) 
      with a primary DSM-III-R diagnosis of mood disorder, which had failed to respond 
      to three or more adequate trials of antidepressant pharmacotherapy. After a 
      thorough diagnostic evaluation, patients received a course of ECT involving 11.2 
      +/- 2.0 (range 8-15) administrations. ECT was commenced with bilateral treatment 
      in 2 adolescents and nondominant right electrode placement in 9 patients; 5 of 
      the 9 patients were subsequently changed to bilateral treatment. All 11 patients 
      improved to a clinically significant degree. Significant improvements were noted 
      in scores on the Children Depression Rating Scale-Revised (CDSR-R) and the Global 
      Assessment of Functioning Scale (GAF) (p < 0.05). Euthymia, defined as CDRS-R 
      score < or = 40, was achieved by 64% (7/11) of patients. The Mini-Mental State 
      Examination showed no significant decline in cognitive functioning. 
      Neuropsychological testing completed in 5 subjects both before ECT and 1-5 days 
      after the last treatment, indicated a significant decline in attention, 
      concentration, and long-term memory search. Minor side effects, experienced 
      within the first 12 hours of treatment, were headache (80% of patients) and 
      nausea/vomiting (64%). The potentially serious complication of tardive seizure 
      (after full recovery of consciousness) occurred in 1 adolescent. Prolonged 
      seizures (> 2.5 minutes) were noted in 7 of the 11 patients (9.6% of the 135 ECT 
      administrations). Pending further research on ECT in youth, it is recommended 
      that ECT should only be administered to youth in hospital settings, that all 
      regularly administered psychotropic medications (including antidepressants) be 
      discontinued before ECT and restarted after the final administration of ECT, and 
      that physicians be aware that 12 treatments are usually sufficient, but that 15 
      treatments may occasionally be necessary for treating depressed adolescents. With 
      the understanding that scientific evaluation of ECT in youth is lacking, it 
      appears that ECT can be an effective and relatively safe treatment for depressed 
      adolescents who have failed to respond to antidepressant pharmacotherapy.
FAU - Ghaziuddin, N
AU  - Ghaziuddin N
AD  - Department of Psychiatry, University of Michigan, Ann Arbor, USA.
FAU - King, C A
AU  - King CA
FAU - Naylor, M W
AU  - Naylor MW
FAU - Ghaziuddin, M
AU  - Ghaziuddin M
FAU - Chaudhary, N
AU  - Chaudhary N
FAU - Giordani, B
AU  - Giordani B
FAU - Dequardo, J R
AU  - Dequardo JR
FAU - Tandon, R
AU  - Tandon R
FAU - Greden, J
AU  - Greden J
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Child Adolesc Psychopharmacol
JT  - Journal of child and adolescent psychopharmacology
JID - 9105358
RN  - 0 (Antidepressive Agents)
SB  - IM
MH  - Antidepressive Agents/therapeutic use
MH  - Child
MH  - Depressive Disorder/psychology/*therapy
MH  - *Electroconvulsive Therapy/methods
MH  - Female
MH  - Humans
MH  - Learning
MH  - Male
MH  - Memory
MH  - Mental Status Schedule
MH  - Neuropsychological Tests
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales
MH  - Treatment Failure
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - 10.1089/cap.1996.6.259 [doi]
PST - ppublish
SO  - J Child Adolesc Psychopharmacol. 1996 Winter;6(4):259-71. doi: 
      10.1089/cap.1996.6.259.