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Table 2 Electroconvulsive therapy use in adolescents: main findings

From: Electroconvulsive therapy use in adolescents: a systematic review

Authors Publication year Journal Main findings
Indications for ECT use in adolescents
Wachtel et al. [6] 2011 Medical Hypotheses The use of ECT in children and adolescents is appropriate for specific clinical indications and urge removal of impediments to ECT access in this population
Baeza et al. [7] 2010 Journal of Child and Adolescent Psychopharmacology ECT is a safe and effective treatment for schizophrenia spectrum disorders in adolescent patients
Consoli et al. [14] 2010 Journal of ECT Electroconvulsive therapy is the effective treatment for catatonia after high-dose benzodiazepine trials in youths
Hazell [1] 2009 Clinical Evidence Electroconvulsive therapy is indicated for a severely obtunded child or adolescent with depression who may, for example, have prolonged psychotic symptoms, and fails to hydrate or maintain caloric intake
Baghai and Moller [16] 2008 Dialogues in Clinical Neuroscience The safety and tolerability of ECT have been enhanced by the use of modified stimulation techniques and by the progress of modern anesthesia, representing a safe treatment that can be offered to all patients, especially after medication failure
Stein et al. [24] 2006 Child & Adolescent Psychiatric Clinics of North America ECT is an effective therapy for severe and resistant depression, with relatively minimal adverse effects
Ghaziuddin et al. [27] 2004 Journal of the American Academy of Child and Adolescent Psychiatry Eligible adolescents for ECT must meet three criteria: diagnosis (severe, persistent major depression or mania, with or without psychosis, schizoaffective disorder, schizophrenia, and others), severity of symptoms, and lack of treatment response
Electroconvulsive therapy: treatment parameters
Shoirah and Hamoda [13] 2011 Expert Review of Neurotherapeutics Although bilateral electrode placement may be more effective than unilateral placement for manic patients, unilateral electrode placement has been found to have equivalent results for other indications
Baeza et al. [7] 2010 Journal of Child and Adolescent Psychopharmacology The mean duration of electroencephalogram seizures was 43.9 ± 16.9 s (range, 20 to 93), with significant differences between males and females
Antunes et al. [15] 2009 Revista Brasileira de Psiquiatria Studies show that high-dose unilateral ECT (UL-ECT) has an equivalent efficacy to bifrontotemporal ECT; however, low-dose UL-ECT has lower efficacy
Efficiency of ECT, associations with other therapies and comparison between techniques
Garg et al. [12] 2011 Indian Journal of Medical Research Patients with treatment-resistant schizophrenia treated with ECT had an improvement in quality of life. All aspects of quality of life got better, except the social relations
Lévy-Rueff et al. [18] 2008 Psychiatry Research Part of a clinical cohort was composed by adolescents. Maintenance ECT in association with pharmacological treatment presented good outcomes for refractory schizophrenia
Bloch et al. [29] 2001 Journal of the American Academy of Child and Adolescent Psychiatry ECT was equally effective in adolescents and adults (58% of remission), but most of adolescents presented psychotic syndromes, instead of affective disorders in adults
Strober et al. [10] 1998 Biological Psychiatry Adolescents aged 13 to 17 years with bipolar depression or major depressive disorder presented 60% of total and 40% of partial remission in a month follow-up
Kutcher and Robertson [34] 1995 Journal of Child and Adolescent Psychopharmacology Patients who accepted ECT improved significantly compared to those who refused. The mean duration of hospital stay was reduced from 176 to 73.8 days
Schneekloth et al. [37] 1993 Convulsive Therapy Retrospective study with a 65% response rate among adolescents between 13 and 18 years old
Paillère-Martinot et al. [39] 1990 Encephale Patients aged 15 to 19 years with different diagnoses achieved 88% of response rate after typical ECT application
Side effects, risks, and complications of ECT for adolescents
Feliu et al. [17] 2008 Neuropsychiatric Disease and Treatment Relatively immediate and significant decreases in multiple areas of memory following ECT, compared with pre-ECT levels of functioning, including verbal memory for word lists, prose passages, and visual memory of geometric designs
Datka et al. [21] 2007 Klinika Psychiatrii CM UJ. One day after first ECT, patient's working memory was slightly impaired. ECT treatment affects working memory function only temporally
Prakash et al. [22] 2006 Journal of ECT ECT presents cognitive side effects especially in recent memory. The post-ECT recovery of various components of cognition was more rapid in patients using donepezil and compared with placebo
Cohen et al. [31] 2000 The American Journal of Psychiatry After a 3.5-year follow-up, patients who received ECT presented similar memory functions to those of psychiatric controls. Poorer cognitive performance is related with greater psychopathology, not with the treatment
Ghazziudin et al. [32] 1999 Journal of Child and Adolescent Psychopharmacology Comparison with pre-ECT and post-ECT tests resulted in significant impairments of concentration and attention, verbal and visual delayed recall, and verbal fluency. Second stage of post-ECT tests (mean, 8.5 months after ECT) showed complete recovery and return to pre-ECT functioning