Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of electroconvulsive therapy.

Hosts: Ravi Bhindi (CC3), Dr. Angad Singh (PGY2)

Audio Editing: Dr. Angad Singh (PGY2)

Show Notes: Dr. Angad Singh (PGY2)

Time Stamps:

(0:36) - What is ECT?

(2:18) - Indications and efficacy

(4:35) - Treatment course

(4:32) - Combination treatment

(6:33) - Medications to discontinue

(8:16) - Contraindications

(9:40) - Side effects

(11:52) - Procedure

(16:03) - Summary

Resources:

• https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/electroconvulsive-therapy
• https://sunnybrook.ca/content/?page=psychiatry-electroconvulsive-therapy-ect-faq

References:

• Andrade, C., Arumugham, S. S., & Thirthalli, J. (2016). Adverse Effects of Electroconvulsive Therapy. The Psychiatric clinics of North America, 39(3), 513–530.

• Brakemeier, E. L., Merkl, A., Wilbertz, G., Quante, A., Regen, F., Bührsch, N., van Hall, F., Kischkel, E., Danker-Hopfe, H., Anghelescu, I., Heuser, I., Kathmann, N., & Bajbouj, M. (2014). Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial. Biological psychiatry, 76(3), 194–202.

• Espinoza, R. T., & Kellner, C. H. (2022). Electroconvulsive therapy. New England Journal of Medicine, 386(7), 667-672.

• Gill, S., Hussain, S., Purushothaman, S., Sarma, S., Weiss, A., Chamoli, S., ... & Loo, C. K. (2023). Prescribing electroconvulsive therapy for depression: Not as simple as it used to be. Australian & New Zealand Journal of Psychiatry, 57(9), 1202-1207.

• Janjua, A. U., Dhingra, A. L., Greenberg, R., & McDonald, W. M. (2020). The efficacy and safety of concomitant psychotropic medication and electroconvulsive therapy (ECT). CNS Drugs, 34(5), 509-520.

• Jelovac, A., Kolshus, E., & McLoughlin, D. M. (2013). Relapse following successful electroconvulsive therapy for major depression: a meta-analysis. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38(12), 2467–2474.

• Kolshus, E., Jelovac, A., & McLoughlin, D. M. (2017). Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials. Psychological Medicine, 47(3), 518-530.

• Lam, R. W., Kennedy, S. H., Adams, C., Bahji, A., Beaulieu, S., Bhat, V., ... & Milev, R. V. (2024). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults: Réseau canadien pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023: Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes. The Canadian Journal of Psychiatry, 69(9), 641-687.

• Luchini, F., Medda, P., Mariani, M. G., Mauri, M., Toni, C., & Perugi, G. (2015). Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response. World journal of psychiatry, 5(2), 182–192.

• Tess, A. V., & Smetana, G. W. (2009). Medical evaluation of patients undergoing electroconvulsive therapy. New England Journal of Medicine, 360(14), 1437-1444.

• Zolezzi M. (2016). Medication management during electroconvulsant therapy. Neuropsychiatric disease and treatment, 12, 931–939.

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