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Porter RJ, Baune BT, Morris G, et al. Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients. BJPsych Open. 2020;6(3):e40doi: 10.1192/bjo.2020.17.
Porter, R. J., Baune, B. T., Morris, G., Hamilton, A., Bassett, D., Boyce, P., Hopwood, M. J., Mulder, R., Parker, G., Singh, A. B., Outhred, T., Das, P., & Malhi, G. S. (2020). Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients. BJPsych open, 6(3), e40. https://doi.org/10.1192/bjo.2020.17
Porter, Richard J, et al. "Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients." BJPsych open vol. 6,3 (2020): e40. doi: https://doi.org/10.1192/bjo.2020.17
Porter RJ, Baune BT, Morris G, Hamilton A, Bassett D, Boyce P, Hopwood MJ, Mulder R, Parker G, Singh AB, Outhred T, Das P, Malhi GS. Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients. BJPsych Open. 2020 Apr 17;6(3):e40. doi: 10.1192/bjo.2020.17. PMID: 32301408; PMCID: PMC7191622.
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BJPsych Open. 2020 Apr 17;6(3):e40. doi: 10.1192/bjo.2020.17.

Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients.

BJPsych open

Richard J Porter, Bernhard T Baune, Grace Morris, Amber Hamilton, Darryl Bassett, Philip Boyce, Malcolm J Hopwood, Roger Mulder, Gordon Parker, Ajeet B Singh, Tim Outhred, Pritha Das, Gin S Malhi

Affiliations

  1. Treatment Algorithm Group; and Department of Psychological Medicine, University of Otago - Christchurch, New Zealand.
  2. Treatment Algorithm Group; and Department of Psychiatry, University of Melbourne, Australia.
  3. Treatment Algorithm Group; Academic Department of Psychiatry, Northern Sydney Local Health District; Sydney Medical School Northern, University of Sydney; and CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, Australia.
  4. Treatment Algorithm Group; and Private Practice in Psychiatry and Division of Psychiatry, the University of Western Australia, Australia.
  5. Treatment Algorithm Group; and Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, University of Sydney, Australia.
  6. Treatment Algorithm Group; School of Psychiatry, University of New South Wales; andBlack Dog Institute, Australia.
  7. Treatment Algorithm Group; and School of Medicine, IMPACT Strategic Research Centre, Deakin University, Australia.

PMID: 32301408 PMCID: PMC7191622 DOI: 10.1192/bjo.2020.17

Abstract

BACKGROUND: Electroconvulsive therapy (ECT) is recommended in treatment guidelines as an efficacious therapy for treatment-resistant depression. However, it has been associated with loss of autobiographical memory and short-term reduction in new learning.

AIMS: To provide clinically useful guidelines to aid clinicians in informing patients regarding the cognitive side-effects of ECT and in monitoring these during a course of ECT, using complex data.

METHOD: A Committee of clinical and academic experts from Australia and New Zealand met to the discuss the key issues pertaining to ECT and cognitive side-effects. Evidence regarding cognitive side-effects was reviewed, as was the limited evidence regarding how to monitor them. Both issues were supplemented by the clinical experience of the authors.

RESULTS: Meta-analyses suggest that new learning is impaired immediately following ECT but that group mean scores return at least to baseline by 14 days after ECT. Other cognitive functions are generally unaffected. However, the finding of a mean score that is not reduced from baseline cannot be taken to indicate that impairment, particularly of new learning, cannot occur in individuals, particularly those who are at greater risk. Therefore, monitoring is still important. Evidence suggests that ECT does cause deficits in autobiographical memory. The evidence for schedules of testing to monitor cognitive side-effects is currently limited. We therefore make practical recommendations based on clinical experience.

CONCLUSIONS: Despite modern ECT techniques, cognitive side-effects remain an important issue, although their nature and degree remains to be clarified fully. In these circumstances it is useful for clinicians to have guidance regarding what to tell patients and how to monitor these side-effects clinically.

Keywords: Depression; cognition; electroconvulsive therapy; memory disorders; neuropsychological tests

References

  1. J Psychiatr Res. 2011 Jun;45(6):770-80 - PubMed
  2. J Clin Psychiatry. 2015 Sep;76(9):e1092-8 - PubMed
  3. Neuropsychopharmacology. 2007 Jan;32(1):244-54 - PubMed
  4. Br J Psychiatry. 2011 Feb;198(2):115-22 - PubMed
  5. Psychol Med. 2017 Jun;47(8):1510-1511 - PubMed
  6. Bipolar Disord. 2018 May;20(3):260-274 - PubMed
  7. J Am Geriatr Soc. 2005 Apr;53(4):695-9 - PubMed
  8. BJPsych Open. 2020 Mar 09;6(2):e26 - PubMed
  9. World J Biol Psychiatry. 2010 Apr;11(3):525-37 - PubMed
  10. Am J Psychiatry. 1995 Jul;152(7):995-1001 - PubMed
  11. Am J Psychiatry. 2016 Apr 1;173(4):408-17 - PubMed
  12. Int J Neuropsychopharmacol. 2015 Jun 19;18(12): - PubMed
  13. BMJ. 2003 Jun 21;326(7403):1363 - PubMed
  14. J ECT. 2008 Mar;24(1):35-9 - PubMed
  15. Bipolar Disord. 2016 Dec;18(8):631-641 - PubMed
  16. J ECT. 2008 Mar;24(1):25-34 - PubMed
  17. Br J Clin Psychol. 1982 Feb;21(1):1-16 - PubMed
  18. J ECT. 2011 Mar;27(1):59-66 - PubMed
  19. J ECT. 2016 Mar;32(1):7-12 - PubMed
  20. J ECT. 2013 Jun;29(2):127-33 - PubMed
  21. Bipolar Disord. 2016 Mar;18(2):102-15 - PubMed
  22. Brain Stimul. 2008 Jan;1(1):16-26 - PubMed
  23. J ECT. 2014 Sep;30(3):177-86 - PubMed
  24. J Affect Disord. 2011 Jul;132(1-2):1-13 - PubMed
  25. Biol Psychiatry. 2007 Sep 1;62(5):400-6 - PubMed
  26. J ECT. 2010 Sep;26(3):157 - PubMed
  27. Arch Gen Psychiatry. 2000 Jun;57(6):581-90 - PubMed
  28. J Psychiatr Res. 2013 Dec;47(12):1967-74 - PubMed
  29. Int J Neuropsychopharmacol. 2008 Nov;11(7):883-90 - PubMed
  30. Biol Psychiatry. 2010 Sep 15;68(6):568-77 - PubMed
  31. J ECT. 2018 Mar;34(1):21-25 - PubMed
  32. Br J Psychiatry. 1998 Jan;172:44-8 - PubMed
  33. Brain Stimul. 2008 Apr;1(2):71-83 - PubMed
  34. Br J Psychiatry. 1997 Mar;170:285-7 - PubMed
  35. J ECT. 2014 Jun;30(2):165-76 - PubMed
  36. J Clin Psychiatry. 1987 Aug;48(8):314-8 - PubMed

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