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

Porter, Richard J, Baune, Bernhard T, Morris, Grace, Hamilton, Amber, Bassett, Darryl, Boyce, Philip, Hopwood, Malcolm J, Mulder, Roger, Parker, Gordon, Singh, Ajeet B, Outhred, Tim, Das, Pritha and Malhi, Gin S 2020, Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients, BJPsych open, vol. 6, no. 3, pp. 1-7, doi: 10.1192/bjo.2020.17.

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Title Cognitive side-effects of electroconvulsive therapy: what are they, how to monitor them and what to tell patients
Author(s) Porter, Richard J
Baune, Bernhard T
Morris, Grace
Hamilton, Amber
Bassett, Darryl
Boyce, Philip
Hopwood, Malcolm J
Mulder, Roger
Parker, Gordon
Singh, Ajeet BORCID iD for Singh, Ajeet B orcid.org/0000-0002-0853-7959
Outhred, Tim
Das, Pritha
Malhi, Gin S
Journal name BJPsych open
Volume number 6
Issue number 3
Article ID e40
Start page 1
End page 7
Total pages 7
Publisher Cambridge University Press
Place of publication Cambridge, Eng.
Publication date 2020-05
ISSN 2056-4724
2056-4724
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Psychiatry
Depression
cognition
electroconvulsive therapy
neuropsychological tests
memory disorders
Summary 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.
Language eng
DOI 10.1192/bjo.2020.17
Indigenous content off
Field of Research 1103 Clinical Sciences
1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30149226

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.