Comparison of clinical efficacy and side effects for bitemporal and bifrontal electrode placement in electroconvulsive therapy

The Journal of ECT
Catherine J BakewellJohn F Neumaier

Abstract

Bifrontal (BF) placement of electrodes in electroconvulsive therapy (ECT) has become a popular alternative to bitemporal (BT) placement. This study compares the clinical efficacy, side effects, and rehospitalization rates of BT and BF electrode placement in a community hospital setting. Charts from 76 patients receiving ECT treatments at Harborview Medical Center from 1994 to 2000 were reviewed to extract data on the characteristics of the course of ECT, clinical response, total headaches, narcotic and nonsteroidal anti-inflammatory drug doses, as well as documentation of confusion, disorientation, memory loss, and treatment emergent need for assistance with activities of daily living. The BT patients experienced more clinical improvement during their stay (a 7-point greater change in Psychiatric Symptom Assessment Scale score, P < 0.05) and were significantly less likely to be rehospitalized within a 1-year time frame (odds ratio = 4.9, P = <0.05), even after controlling for relevant covariates. Although the two patient groups had equal rates of headache and analgesic administration, the BT placement caused significantly more cognitive impairment. This study suggests that BT electrode placement offers better efficacy but modes...Continue Reading

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Citations

Feb 24, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·Paul E Holtzheimer, Charles B Nemeroff
Jun 28, 2006·The Journal of ECT·Heath R Penland, Robert B Ostroff
Jun 22, 2010·The Journal of ECT·Charles H KellnerJessica Wiegand
Sep 2, 2010·The Journal of ECT·Angel V PeterchevSarah H Lisanby
Jun 19, 2010·Journal of Affective Disorders·Harve Shanmugam VirupakshaBangalore N Gangadhar
Nov 18, 2006·Expert Opinion on Pharmacotherapy·Paul E Holtzheimer, Charles B Nemeroff
May 17, 2019·The Journal of ECT·Takashi TsujiiHiroyuki Uchida
Jul 1, 2009·Revista brasileira de psiquiatria : orgão oficial da Associação Brasileira de Psiquiatria, Asociación Psiquiátrica de la América Latina·Paula Barros AntunesMarcelo P Fleck
Nov 26, 2019·The Journal of ECT·Takashi TsujiiHiroyuki Uchida
Jul 27, 2006·The Australian and New Zealand Journal of Psychiatry·Colleen K LooChris Pratt

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