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Medication Treatment Failure And Ect

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Medication Treatment Failure And Ect

  1. 1. Medication Resistance and ECT. Is there a problem? by Walter van den Broek
  2. 3. The indication for ECT has changed: Medication Resistant Depression.
  3. 4. Should you worry about that?
  4. 5. You’re concerned about medication resistance and response to ECT p =0.004 p <0.05 Prudic, J et al. Journal of Psychiatric Research 1990
  5. 6. This didn’t help to resolve your concern Prudic, J. et al. Am J Psychiatry, 1996 ATHF<3, n=18 ATHF 3 or more, n=36 Response 94% 64%
  6. 8. Medication resistance according to the ATHF does not influence remission and response to subsequent ECT
  7. 9. van den Broek, et al, Journal of Clin Psychopharmacology 2004
  8. 10. Co variables and their fate
  9. 11. Characteristics of the treatment TCA Lithium MAO ECT
  10. 12. Medication resistance with TCA and lithium does not influence remission and response to subsequent ECT
  11. 13. SSRIs are less efficacious than TCAs with depressed inpatients
  12. 14. Comparison of imipramine and lithium addition or fluvoxamine and lithium addition
  13. 15. ECT after Lithium addition Journal of Clin Psychiatry in press
  14. 16. Others haven’t found an influence of ATHF medication resistance on response to subsequent ECT
  15. 17. Real World Patients?
  16. 18. Husain et al, Journal of Affective Disorders, 2004.
  17. 19. CORE
  18. 21. p =0.004 p <0.05 Prudic, J et al. Journal of Psychiatric Research 1990
  19. 22. Prudic, J. et al. Am J Psychiatry, 1996 ATHF<3, n=18 ATHF 3 or more, n=36 Response 94% 64%
  20. 24. Answers Anyone?

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