Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT
Background: Bifrontal (BF) placement of electrodes in electroconvulsive therapy (ECT) has emerged as an alternative option to the conventional bitemporal (BT) and right unilateral electrode placement in view of fewer cognitive adverse effects. However, the results have been contradictory in terms of...
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SAGE Publishing
2011-01-01
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| Series: | Indian Journal of Psychological Medicine |
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| Online Access: | http://www.ijpm.info/article.asp?issn=0253-7176;year=2011;volume=33;issue=1;spage=66;epage=70;aulast=Viswanath |
| _version_ | 1819096188535701504 |
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| author | Biju Viswanath Janardhanan C Narayanaswamy Jagadisha Thirthalli B N Gangadhar |
| author_facet | Biju Viswanath Janardhanan C Narayanaswamy Jagadisha Thirthalli B N Gangadhar |
| author_sort | Biju Viswanath |
| collection | DOAJ |
| description | Background: Bifrontal (BF) placement of electrodes in electroconvulsive therapy (ECT) has emerged as an alternative option to the conventional bitemporal (BT) and right unilateral electrode placement in view of fewer cognitive adverse effects. However, the results have been contradictory in terms of clinical efficacy. Materials and Methods: We studied the records of all patients referred for ECT between the months of August 2008 and July 2010 (n=1575). One hundred and five of these patients had received BF-ECT. These records were compared with the records of 105 patients who received BT-ECT. For each patient who received BF-ECT, the very next person posted for BT-ECT was taken as the control. All patients received bilateral ECTs at 1.5-times the threshold stimulus dose. The number of ECTs administered, duration of hospital stay after ECT initiation, seizure threshold and failure to achieve adequate seizures were compared. Two raters who achieved good inter-rater reliability assessed the initial severity using the clinical global impression scale and clinical improvement using a Likert scale. Results: The speed of response, as assessed by the number of ECTs received and the duration of hospital stay after ECT initiation was similar in the two groups. In addition, both groups were comparable in terms of clinical improvement scores on the Likert scale. BF-ECT patients also had a significantly higher seizure threshold, which remained significant in spite of controlling for age. This study is chart based, with its inherent limitations. Standard outcome measures were not used. Cognitive adverse effects were not studied. Conclusions: BF-ECT performed similar to BT-ECT with regard to therapeutic efficacy. Given the consistent results of the former, with fewer cognitive side-effects, the findings of the present study support BF-ECT as the first line for electrode application. |
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| institution | Directory Open Access Journal |
| issn | 0253-7176 |
| language | English |
| last_indexed | 2024-12-21T23:55:14Z |
| publishDate | 2011-01-01 |
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| record_format | Article |
| series | Indian Journal of Psychological Medicine |
| spelling | doaj.art-3a3f9a7f6ede42abb259fc56e887a0b92022-12-21T18:45:49ZengSAGE PublishingIndian Journal of Psychological Medicine0253-71762011-01-01331667010.4103/0253-7176.85398Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECTBiju ViswanathJanardhanan C NarayanaswamyJagadisha ThirthalliB N GangadharBackground: Bifrontal (BF) placement of electrodes in electroconvulsive therapy (ECT) has emerged as an alternative option to the conventional bitemporal (BT) and right unilateral electrode placement in view of fewer cognitive adverse effects. However, the results have been contradictory in terms of clinical efficacy. Materials and Methods: We studied the records of all patients referred for ECT between the months of August 2008 and July 2010 (n=1575). One hundred and five of these patients had received BF-ECT. These records were compared with the records of 105 patients who received BT-ECT. For each patient who received BF-ECT, the very next person posted for BT-ECT was taken as the control. All patients received bilateral ECTs at 1.5-times the threshold stimulus dose. The number of ECTs administered, duration of hospital stay after ECT initiation, seizure threshold and failure to achieve adequate seizures were compared. Two raters who achieved good inter-rater reliability assessed the initial severity using the clinical global impression scale and clinical improvement using a Likert scale. Results: The speed of response, as assessed by the number of ECTs received and the duration of hospital stay after ECT initiation was similar in the two groups. In addition, both groups were comparable in terms of clinical improvement scores on the Likert scale. BF-ECT patients also had a significantly higher seizure threshold, which remained significant in spite of controlling for age. This study is chart based, with its inherent limitations. Standard outcome measures were not used. Cognitive adverse effects were not studied. Conclusions: BF-ECT performed similar to BT-ECT with regard to therapeutic efficacy. Given the consistent results of the former, with fewer cognitive side-effects, the findings of the present study support BF-ECT as the first line for electrode application.http://www.ijpm.info/article.asp?issn=0253-7176;year=2011;volume=33;issue=1;spage=66;epage=70;aulast=ViswanathBifrontalbitemporaleffectivenesselectroconvulsive therapy |
| spellingShingle | Biju Viswanath Janardhanan C Narayanaswamy Jagadisha Thirthalli B N Gangadhar Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT Indian Journal of Psychological Medicine Bifrontal bitemporal effectiveness electroconvulsive therapy |
| title | Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT |
| title_full | Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT |
| title_fullStr | Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT |
| title_full_unstemmed | Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT |
| title_short | Effectiveness of bifrontal ECT in practice: A comparison with bitemporal ECT |
| title_sort | effectiveness of bifrontal ect in practice a comparison with bitemporal ect |
| topic | Bifrontal bitemporal effectiveness electroconvulsive therapy |
| url | http://www.ijpm.info/article.asp?issn=0253-7176;year=2011;volume=33;issue=1;spage=66;epage=70;aulast=Viswanath |
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