Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-02T18:50:12.775Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuroendocrine and clinical effects of electroconvulsive therapy and their relationship to treatment outcome

Published online by Cambridge University Press:  09 July 2009

J. Smith ,
K. Williams ,
S. Birkett ,
H. Nicholson ,
P. Glue  and
D. J. Nutt
J. Smith*
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
K. Williams
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
S. Birkett
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
H. Nicholson
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
P. Glue
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
D. J. Nutt
Affiliation:
Fromeside Clinic, Bristol; Stonebow Unit, Hereford County Hospital, Department of Anatomy and the Psychopharmacology Unit, University of Bristol
*
1Address for correspondence: Dr Jeanette Smith, Fromeside Clinic, Blackberry Hill, Stapleton, Bristol BS16 1ED
Get access Rights & Permissions [Opens in a new window]

Synopsis

Two groups of variables, endocrine and clinical, have been reported to have predictive value in determining response to electroconvulsive therapy (ECT) in depressed patients. Baseline levels of oxytocin associated neurophysin (OAN) and peak OAN response to ECT may predict clinical outcome, while the presence of delusional symptoms may indicate favourable initial response to ECT. The purpose of this study was to examine the relationship between these variables on initial and longer term response over a course of ECT, using a direct measure of plasma oxytocin concentrations. A substantial and immediate increase in oxytocin was seen after the first ECT, with significantly attenuated responses after the third and fifth ECTs. Increased plasma vasopressin concentrations were seen after all ECT treatments, each response being of similar magnitude. No associations were found between either endocrine baseline levels or peak responses, and clinical outcome. Only clinical variables predicted outcome, as patients with psychotic symptoms had more rapid initial response to ECT, and patients who had relapsed 2 months after the end of ECT had significantly higher depression ratings at day 14 of treatment than treatment responders.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 547 - 555
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abrams, R., Fink, M. & Feldstein, S. (1973). Prediction of clinical response to ECT. British Journal of Psychiatry 122, 457–460.CrossRefGoogle ScholarPubMed
Carney, M. W. P., Roth, M. & Garside, R. F. (1965). The diagnosis of depression syndromes and the prediction of ECT response. British Journal of Psychiatry 111, 659–674.CrossRefGoogle Scholar
Crow, T. J., Deakin, J. F. W., Johnstone, E. C., MacMillan, J. F., Owens, D. G. C., Lawler, P., Frith, C. D., Stevens, M. & McPherson, K. (1984). The Northwick Park ECT Trial: predictors of response to real and simulated ECT. British Journal of Psychiatry 144, 227–237.Google Scholar
Fink, M. & Johnson, L. (1982). Monitoring the duration of electroconvulsive therapy seizures. Archives of General Psychiatry 39, 1189–1191.CrossRefGoogle ScholarPubMed
Greenwood, F. C., Hunter, W. M. & Glover, J. S. (1963). The preparation of I-131-labelled human growth hormone of high specific radioactivity. Biochemistry Journal 89, 114–123.CrossRefGoogle ScholarPubMed
Griffiths, E. J., Lorenz, R. P., Baxter, S. & Talon, N. S. (1989). Acute neurohumeral response to electroconvulsive therapy during pregnancy: a case report. Journal of Reproductive Medicine for Obstetricians and Gynaecologists 34, 907–911.Google Scholar
Hamilton, M. A. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Hamilton, M. & White, J. M. (1960). Factors related to the outcome of depression treated with ECT. Journal of Mental Science 106, 1031–1041.CrossRefGoogle Scholar
Hobson, R. F. (1953). Prognostic factors in electric convulsive therapy. Journal of Neurology, Neurosurgery and Psychiatry 16, 275–281.CrossRefGoogle ScholarPubMed
Ivell, R. & Richter, D. (1983). Partial sequence of rat OT gene. In Biochemical and Clinical Aspects of Neuropeptides (ed. Koch, G. and Richter, D.), pp. 259–265. Academic Press: New York.Google Scholar
Mendels, J. (1967). The prediction of response to electroconvulsive therapy. American Journal of Psychiatry 124, 153–159.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.CrossRefGoogle ScholarPubMed
Ottosson, J. O. (1960). Experimental studies on the mode of action of electroconvulsive therapy. Acta Psychiatrica et Neurologica Scandinavica 145, (supplement) 1–141.Google Scholar
Roberts, J. M. (1959). Prognostic factors in the electroshock treatment of depressive states. I. Clinical features from history and examination. Journal of Mental Science 105, 693–702.CrossRefGoogle ScholarPubMed
Sackheim, H. A., Deccina, P., Prohovnik, I., Portnoy, S., Kanzler, M. & Malitz, S. (1986). Dosage, seizure threshold and the antidepressant efficacy of electroconvulsive therapy. In Electroconvulsive Therapy: Clinical and Basic Research Issues (ed. Malitz, S. and Sackheim, H. A.), pp. 398–410. Academy of Science: New York.Google Scholar
Scott, A. I. F., Whalley, L. G., Bennie, J. & Bowler, G. (1986). Oestrogen-stimulated neurophysin and outcome after electroconvulsive therapy. Lancet i, 1411–1414.CrossRefGoogle Scholar
Scott, A. I. F., Whalley, L. J. & Legros, J. (1989). Treatment outcome, seizure duration and the neurophysin response to ECT. Biological Psychiatry 25, 585–597.CrossRefGoogle ScholarPubMed
Sørensen, P. S., Hammer, M. & Bolwig, T. G. (1982). Vasopressin release during electroconvulsive therapy. Psychoneuroendocrinology 7, 303–308.Google Scholar
Weiner, R. D. (1979). The psychiatric use of electrically induced seizures. American Journal of Psychiatry 136, 1507–1517.Google ScholarPubMed
Weizman, I. G., Grupper, D., Tyano, S. & Laron, Z. (1987). The effect of acute and repeated electroconvulsive treatment on plasma beta-endorphin, growth hormone, prolactin and cortisol secretion in depressed patients. Psychopharmacology 93, 122–126.CrossRefGoogle ScholarPubMed
Whalley, L. J., Eagles, J. M., Bowler, G. M. R., Benie, J. G., Dick, H. R., McGuire, R. J. & Fink, G. (1987). Selective effects of ECT on hypothalamic-pituitary activity. Psychological Medicine 17, 319–328.CrossRefGoogle ScholarPubMed