It has been suggested that higher glucocorticoid levels may predispose to more severe ectinduced amnesia because of the positive modulatory effect that glucocorticoids have on nmda receptors chamberlin and tsai, 1998. But, if ectinduced hypercortisolemia stimulates hippocampal neurons to a pathological degree, it would contribute to ectinduced cognitive impairment. Typically, anterograde amnesia resolves within a few weeks whereas retrograde amnesia is more persistent 8. Investigation of the possible role of shankapushpi in the attenuation of ect induced amnestic deficits article pdf available in indian journal of psychiatry 542.
Ect are a retrograde amnesia covering the period im mediately before treatment is administered and an antero grade amnesia covering the period immediately afterwards. The anatomy of memory analysis of the locus of brain lesions in patients such as h. Based on this putative mechanism, an nmethyldaspartate receptor antagonist would appear suitable for preventing the retrograde amnesia. However, listeners may be surprised and even amused to learn that, with the assistance of able students, colleagues, and collaborators at my institute and elsewhere, my fields of.
In this fullyrevised fourth edition of what has long been the standard textbook for the field, dr. Certain pharmacological agents administered during electroconvulsive therapy may have the potential to prevent persistent retrograde amnesia induced during electroconvulsive therapy. Stemcued recall was poor retrograde amnesia, but priming on wordstem completion was preserved. An old and yet persistent misunderstanding among lay persons is that the transient amnesia associated with ect was efficacious because ect caused patients to forget their troubles. Electroconvulsive therapy ect is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. It is caused by an injury or the onset of a disease. Ect seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.
Patients studied a list of words just prior to ect and then received memory tests for those words after recovering from. The ect procedure was first conducted in 1938 and rapidly replaced less safe and effective forms of biological treatments in use at the time. Electroconvulsive therapy ect is handsdown the most contr oversial treatment in modern psychiatry. Despite the disruptive effects of the ect induced amnesia, it remains very much on the table as a treatment option for me. Although it is primarily utilized to treat patients with severe depression, patients with schizophrenia, schizoaffective disorder, catatonia, neuroleptic malignant syndrome, and bipolar disorder may also benefit. Pdf investigation of the possible role of shankapushpi. However, neurocognitive sideeffects such as anterograde amnesia still regularly occur. Glucocorticoid mechanisms may contribute to ectinduced. One of the most controversial treatments for such disorders is electroshock therapy, more commonly known as electroconvulsive therapy ect. Electroconvulsive therapy ect is considered an effective treatment for major depression with melancholic features. Amnesia from neurologic conditions is often accompanied by other neuropsychologic and physical abnormalities. Electroconvulsive therapy ect is frequently used in the treatment of various mental disorders. Full text propofol prevents electroconvulsiveshockinduced. Electroconvulsive therapyinduced persistent retrograde.
Electroconvulsive therapy is a procedure in which electricity is passed through the brain to induce seizures in a patient. The clinical application of ect is limited mainly because of side effects like memory impairment1 many methods have been recommended to reduce ect induced amnesia like. Pdf priming and recognition were tested in patients receiving electroconvulsive therapy ect for treatment of a psychiatric disorder. No other treatment has generated such a fierce and polarized public debate. Priming and recognition in ectinduced amnesia springerlink. The memory can be either wholly or partially lost due to the extent of damage that was caused. In humans, the glucocorticoid dexamethasone has been shown to significantly worsen ectinduced amnesia horne et al. This study examined the short and longterm effects of differing forms of ect on memory of personal and impersonal public events. Convulsive therapy, with chemically induced seizures, was first. Retrograde amnesia after electroconvulsive therapy.
Navigator next brief psychotic disorder cluster a personality disorder. Some patients are disoriented or experience amnesia when they wake up. Psychogenic disorder an overview sciencedirect topics. Electroconvulsive therapy causes permanent amnesia and.
In 1988 su meck was twentytwo and married with two children when a ceiling fan in her kitchen fell and struck her on the head, leaving her with a. Priming and recognition were tested in patients receiving electroconvulsive therapy ect for treatment of a psychiatric disorder. Voltage of electroshock therapy the physics factbook. I would probably ask for outpatient ect right now if it werent for the requirement that someone be available to take you home after treatments and keep an eye on you a safety precaution because of the use of general. Inducing amnesia of daily events by trying to forget.
Searching for the mechanisms of ects therapeutic effect. For fans of susannah cahalans brain on fire, the courageous memoir of a woman robbed of all her memories by a traumatic brain injuryand her more than twentyfiveyear struggle to reclaim her life. Besides finding that ect routinely causes substantial and permanent amnesia, the study contradicts sackeims oftpublished statements that ect increases intelligence and that patients who report permanent adverse effects are mentally ill. Retrograde amnesia associated with ecs has been studied most commonly using the passive avoidance paradigm e. It tends to negatively affect episodic, autobiographical, and declarative memory, while keeping procedural memory intact without increasing difficulty for learning new information. Retrograde amnesia ra is a loss of memoryaccess to events that occurred, or information that was learned in the past.
One observation even noted that ect conferred protection against the druginduced parkinsonism. On psychiatric interview, she has no clearcut delusions, nor does she experience hallucinations. Retrograde amnesia is the inability to retrieve information that. Anterograde and retrograde amnesia are common ectrelated cognitive complaints. Both ecsinduced mcr subsensitivity and a clinically equivalent model of ectinduced anterograde amnesia were not demonstrable after a single ecs, were cumulatively induced by repeated treatments. The perplexing history of ect in three books psychiatric times. This misconception was no doubt borne out of the more intense amnesia that was associated with older, nowabandoned forms of ect, such as bilateral sine wave ect. Retrograde amnesia following electroconvulsive therapy nature. Hundreds of new clinical studies called from the more than 1500 published since the third edition appeared have been. Patients may indicate that they have dense amnesia extending far back into the past for events of personal significance or that broad as of cognitive function are so impaired that the patients are no longer able to engage in former occupationsin some patient selfreports of profound ect induced deficits may reflect objective loss of function. Disruption of long term potentiation as a mechanism for electroconvulsive therapyinduced retrograde amnesia is well supported. It is very rare, despite being a popular theme for movies and books.
Ect added to the concurrent antipsychotic medication benefitted schizophrenia patients. However, ect may have adverse effects on cognition. Electroconvulsive therapy ect is now an accepted treatment for certain psychiatric disorders. Request pdf retrograde amnesia after electroconvulsive therapy. In a patient under intravenous sedation or general anesthesia, electroconvulsive therapy ect uses an electric current to create a generalized cerebral seizure. Electroconvulsive therapy statpearls ncbi bookshelf. A novel instrument was used, and the reporting of event dating and details. But, if ectinduced hypercortisolemia stimulates hippocampal neurons to a pathological degree, it would contribute to. Electroconvulsive therapy ect as a single course or in maintenance form mect is an effective treatment in depressed elderly.
These observations provide a novel insight into potential targets for. Molecular mechanisms underlying electroconvulsive therapy. A comprehensive discussion of electroconvulsive therapy by a distinguished clinicianresearcher, this fine work traces the techniques development from the 16th century to the present, and offers a stepbystep guide to the treatment sequence. Ect induces anterograde and retrograde amnesia, as well as nonmemory. In particular, explicit memory seems to be affected which may cause anterograde and retrograde amnesia, whereas implicit memory seems to be. Critics of ect say its a crude tool of psychiatric coercion.
Propofol has risen in popularity in the last decade as the anesthetic of choice for ect, largely. However, ect induced amnesia is usually transient, and extensive recovery of memory occurs with time. Bilateral ect caused more marked amnesia for events and details than rul. Richard abrams once again demonstrates his unique ability to analyze and present a wealth of newand often technical material in a lucid, compelling, and highly readable fashion.
Amnesia is a deficit in memory caused by brain damage or disease, but it can also be caused temporarily by the use of various sedatives and hypnotic drugs. Background retrograde amnesia is the most persistent cognitive adverse effect of electroconvulsive therapy ect. Anterograde amnesia during electroconvulsive therapy. Books on memory and its disorders have never been in short supply. Expectedly, schizophrenia was the first condition tested in comparative trials of ect. Electroconvulsive therapy ect, formerly known as electroshock therapy, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from mental disorders. If ectinduced hypercortisolemia stimulates hippocampal neurons physiologically, the transient hypercortisolemia could be a natural though incompletely effective defense against ectinduced cognitive impairment.
Ect is reported to cause anterograde amnesia an inability to form new memories, but this is usually restricted to the period immediately following the ect. The role of retrieval processes in some aspects of ectinduced amnesia has been discussed by squire and suggested by williams. The study is a stunning selfrepudiation of a 25year career, andre said. The effects of electroconvulsive therapy on memory of. Contemporary use and practice of electroconvulsive therapy worldwide. Email your librarian or administrator to recommend adding this book to your organisations collection. The author describes the general medical and cerebral physiology of ect, the treatment of highrisk patients, memory and cognitive effects of unilateral. Although effective for treating mood disorders, ect almost invariably produces a transient amnesia for events that occurred shortly before or after treatment. Both types of amnesia are more common with bilateral stimulation, highintensity electrical dosage, and sinus waveform stimulus 11. Amnesia is when a person can no longer memorize or recall information that is stored in memory. A clinical textbook of memory disorders in their resource library and will value it as a practical handbook that covers amnesia syndromes likely to be encountered in neurological or psychological patients. When we try to forget something unpleasant, whether a bad argument or a traumatic event, we may be unintentionally inducing amnesia of unrelated memories. Glucocorticoid mechanisms may contribute to ect induced retrograde amnesia article in psychopharmacology 1901. These seizures are induced using very brief bursts of alternating current.
1535 1229 1268 860 1601 13 1172 454 227 356 534 903 421 51 355 177 1525 585 1482 653 1138 387 589 1091 683 1344 480 1478 57 945 270 437 182 315 310