An Update on Neuromodulation Techniques for Older Adults

Topics: Anxiety | Deep brain stimulation (DBS) | Dementia | Depression | ECT | Electroconvulsive therapy | magnetic seizure therapy (MST) | mild cognitive impairment | Neuromodulation | Obsessive compulsive disorder/OCD | Personality Disorders | SAINT protocol | Theta burst stimulation | TMS | Transcranial direct current stimulation (TDCS) | Transcranial Magnetic Stimulation | Vagus nerve stimulation (VNS)

CGPR: One of the more interesting neuromodulation interventions is magnetic seizure therapy (MST). How does it work? Dr. Lisanby: MST is an investigational form of treatment for depression. Similar to electroconvulsive therapy (ECT), MST induces seizures with the intention of therapeutic benefit, but the big difference between MST and ECT is how the se

Electroconvulsive Therapy: A Primer

Topics: brief pulse | Depression | ECT | Innovations | Ketamine | maintenance ECT | memory loss | retrograde amnesia | Stigma | Suicidality | TMS | unilateral vs bilateral

CHPR: Welcome, Dr. Seiner. Can you tell us what led to your interest in electroconvulsive therapy (ECT) and neurotherapeutics? Dr. Seiner: I went to the University of Michigan and got a degree in chemical engineering, but I decided I didn’t want to fractionate oil for a living, so I went to medical school thinking I would be an internist. While in me

Melatonin vs Memantine for ECT-Related Cognitive Impairment

Topics: Cognitive impairment | ECT | Melatonin | Memantine

Review of: Sarraf N et al, J Clin Neurosci 2020;74:146–150 Many patients hesitate to accept ECT because of the treatment’s adverse effects on cognitive function. Memantine (Namenda)—an NMDA receptor antagonist approved for the treatment of Alzheimer’s disease—has been shown to be more effective than placebo in preventing cognitive impairmen

Getting Uncomfortable with Esketamine

Topics: Antidepressant Augmentation | Antidepressants | Brain Devices | Depression | Depressive Disorder | ECT | Esketamine | Free Articles | Ketamine | Neurotoxicity | Novel Medications | rTMS | Suicidality | TMS | Transcranial Magnetic Stimulation | Treatment-Resistant Depression

Esketamine (Spravato) was approved for treatment-resistant depression in 2019. In this interview, Dr. Williams (who has no relationship with Janssen Pharmaceuticals, Inc) addresses some lingering doubts that have been raised about the medicine. TCPR: Where does esketamine fit in the list of interventional therapies for depression, like repetitive tra

Structural Brain Changes After ECT for Depression

Topics: ECT | Neuroscience in Psychiatry | Psychotic Depression | Treatment-Resistant Depression

REVIEW OF: Gryglewski G et al, Brain Stimul 2021;14(4):927–937 STUDY TYPE: Meta-analysis Electroconvulsive therapy (ECT) has high antidepressant potency, boasting an impressive response rate of up to 80%. However, despite decades of research, we still have little understanding of its mechanism of action. Although several structural brain changes hav

Pilot Study of Ketamine vs ECT for Major Depression

Topics: ECT | Esketamine | Ketamine | Suicide | Treatment-Resistant Depression

REVIEW OF: Kheirabadi D et al, J Clin Psychopharm 2020;40(6):588–593 STUDY TYPE: Randomized controlled trial Electroconvulsive therapy (ECT) has long been the gold standard for severe or treatment-refractory depression (TRD). However, it has two major drawbacks: it involves anesthesia and it may be associated with memory impairment. Ketamine has

ECT Worked: Now What?

Topics: Antidepressant Augmentation | Depression | Depressive Disorder | ECT | Free Articles | Lithium | Treatment-Resistant Depression

Juan is a 72-year-old man with severe depression who has not responded to numerous antidepressant trials. He is reluctant to undergo a course of electroconvulsive therapy (ECT), but agrees to do so if one last medication trial doesn’t work. After failing to respond to escitalopram augmented with aripiprazole, Juan receives a course of ECT and has a te