thiopental and Mental-Disorders

Over the past several decades, psychopharmacological treatments in psychiatry have been subjected to intensive methodological scrutiny in the continual assessment of their efficacy and safety. Although one of the most dramatic and controversial therapeutic approaches in psychiatry, electroconvulsive therapy (ECT) has not received the same concentrated, systematic attention. Through a comprehensive literature search, the present authors have attempted to provide answers relating to the efficacy and the safety of conventional ECT and some of its more prominent variations. Although specific discernible trends are reported in the text, results of the survey are too disparate for a simplistic summary statement to be made regarding efficacy in all diagnostic categories. As with most somatic treatments in psychiatry, bilateral ECT does present some apparent risk, reduced but not entirely eliminated by precautionary techniques, which must be weighed against the possible benefits to be derived in a given case. Other variations of ECT offer promise of fewer side effects but must be accepted as standard clinical practice.

Topics: Acute Disease; Anesthesia; Anesthesia, Inhalation; Anesthesia, Intravenous; Chronic Disease; Clinical Trials as Topic; Depression; Electric Stimulation; Electroconvulsive Therapy; Histamine; Humans; Insulin; Length of Stay; Mental Disorders; Nitrous Oxide; Psychotherapy; Safety; Schizophrenia; Succinylcholine; Thiopental; Tranquilizing Agents

Electroconvulsive therapy (ECT) is among the most effective treatments of several life-threatening psychiatric disorder. Despite effective therapy, ECT-induced seizure could cause several adverse effects including cognitive disorders and memory impairment. Drugs such as thiopental, which have been prescribed for anesthesia required for ECT, are known as drugs with cognitive effects. This pilot randomized clinical trial tried to assess the feasibility of using a lower dose of thiopental in combination with remifentanil instead of a higher challenging dose of a single drug with cognitive side effects such as thiopental. We evaluated post-ECT cognitive impairment in patients who received remifentanil-thiopental compared with thiopental-placebo group.. One hundred twenty patients with psychiatric disorders between the ages of 18 and 60 years were enrolled. The patients were randomized into 2 groups who received either thiopental sodium (4 mg/kg) and remifentanil (1 μg/kg) or thiopental sodium (3 mg/kg, placebo). The psychiatric patients were examined using mini-mental state examination in terms of the cognitive deficits before ECT as well as 5 and 24 hours after ECT. Statistical analyses were done using Statistical Package for the Social Sciences version 16. Unpaired t test, χ2 test, and analysis of variance were used to determine the association of variables.. All the patients completed the trial. There were no reports of adverse effects. In terms of depth of anesthesia measured by bispectral index, no significant difference was observed. Regarding mini-mental state examination scores, the difference was not statistically significant.. Depth of anesthesia was similar between the groups.

Topics: Adolescent; Adult; Anesthesia; Anesthetics, Intravenous; Cognition Disorders; Consciousness Monitors; Double-Blind Method; Electroconvulsive Therapy; Female; Hemodynamics; Humans; Male; Mental Disorders; Middle Aged; Neuropsychological Tests; Pilot Projects; Piperidines; Remifentanil; Thiopental; Young Adult

This study aimed to compare the effects of propofol, thiopental, and etomidate, which are routinely used in anesthesia for electroconvulsive therapy (ECT), on the cardiovascular system, seizure variables, recovery, cognitive functions, and response to treatment.. Male patients hospitalized at the Seventh Psychiatry Clinics of the Bakırköy Teaching Hospital for Psychiatry, Neurology, and Neurosurgery who were treated with ECT were investigated prospectively. The effects on cardiovascular system parameters (heart rate, blood pressure, and blood oxygenation), seizure variables (duration and intensity of seizure), and recovery variables were recorded at every session, on prespecified time points, and the findings of the first session were used in this evaluation. In addition, clinical responses to treatment were evaluated with tests of cognitive functions before and after a course of ECT. Adverse effects were recorded.. The sociodemographic characteristics of the 3 treatment groups were similar. There were no significant differences among the groups in terms of effects on cardiovascular system variables, seizure variables, and cognitive functions. The clinical response to ECT was good in all groups, without any significant differences.. Propofol, etomidate, and thiopental are associated with similar safety and efficacy profiles.

Topics: Adult; Anesthesia Recovery Period; Anesthesia, Intravenous; Anesthetics, Intravenous; Cognition; Double-Blind Method; Drug Interactions; Electroconvulsive Therapy; Electroencephalography; Etomidate; Female; Hemodynamics; Humans; Male; Mental Disorders; Middle Aged; Propofol; Seizures; Socioeconomic Factors; Thiopental; Young Adult

General anesthesia is required for Electroconvulsive Therapy (ECT) and it is usually provided by a hypnotic agent. The seizure duration is important for the treatment, and it is usually accompanied by severe hemodynamic changes. The aim of this study was to compare the effects of sodium thiopental versus Propofol on seizure duration and hemodynamic variables during ECT.. A number of 100 patient-sessions of ECT were included in this randomized clinical trial. The initial hemodynamic state of each patient was recorded. Anesthesia was induced by Sodium thiopental in the 1st group and with Propofol in 2nd group. All the patients received the muscle relaxant succinylcholine. The hemodynamic variables after seizure and seizure duration were recorded. The data were analyzed through SPSS 20 and independent t-test. P<0.05 was considered significant.. The mean duration of seizure in the sodium thiopental group was significantly longer than the Propofol group (40.3±16.6 sec versus 32±11.3 sec) (P=0.001). There was no statistically significant difference between the mean energy level applied in the two groups (20.5±3.81 joules in the sodium thiopental versus 20.2±3.49 joules in the Propofol group). The mean systolic and diastolic blood pressure at all times after seizure and mean heart rate at 3 and 5 minutes after seizure were significantly lower in Propofol than sodium thiopental groups.. Propofol provides a more stable hemodynamic state for the ECT procedures, and its use is highly preferred over sodium thiopental in patients with cardiovascular disease.

Topics: Adolescent; Adult; Double-Blind Method; Electroconvulsive Therapy; Female; Hemodynamics; Humans; Hypnotics and Sedatives; Iran; Male; Mental Disorders; Middle Aged; Propofol; Prospective Studies; Seizures; Thiopental

Over the past several decades, psychopharmacological treatments in psychiatry have been subjected to intensive methodological scrutiny in the continual assessment of their efficacy and safety. Although one of the most dramatic and controversial therapeutic approaches in psychiatry, electroconvulsive therapy (ECT) has not received the same concentrated, systematic attention. Through a comprehensive literature search, the present authors have attempted to provide answers relating to the efficacy and the safety of conventional ECT and some of its more prominent variations. Although specific discernible trends are reported in the text, results of the survey are too disparate for a simplistic summary statement to be made regarding efficacy in all diagnostic categories. As with most somatic treatments in psychiatry, bilateral ECT does present some apparent risk, reduced but not entirely eliminated by precautionary techniques, which must be weighed against the possible benefits to be derived in a given case. Other variations of ECT offer promise of fewer side effects but must be accepted as standard clinical practice.

Topics: Acute Disease; Anesthesia; Anesthesia, Inhalation; Anesthesia, Intravenous; Chronic Disease; Clinical Trials as Topic; Depression; Electric Stimulation; Electroconvulsive Therapy; Histamine; Humans; Insulin; Length of Stay; Mental Disorders; Nitrous Oxide; Psychotherapy; Safety; Schizophrenia; Succinylcholine; Thiopental; Tranquilizing Agents

Topics: Anesthetics; Desflurane; Humans; Mental Disorders; Thiopental

Many factors influence seizure duration associated with electroconvulsive therapy (ECT). This is a chart review study to assess seizure duration measured with both electroencephalography and electromyography after anesthetic induction with either thiopentone or etomidate. Thirty-seven patients receiving ECT for depression were entered into the study, and a pair of seizures was measured from each patient. Alternate induction agents were used in sequential pairings, and the study was controlled for interval between seizures, laterality, and percent energy. Etomidate was associated with a significantly (p = 0.0002, F = 15.84, df = 1, analysis of variance) longer seizure duration (mean = 34.43 s, SD = 16.06) than thiopentone (mean = 21.73 s, SD = 9.33).

Topics: Adolescent; Adult; Aged; Anesthesia; Anesthetics, Intravenous; Depressive Disorder, Major; Electroconvulsive Therapy; Etomidate; Female; Humans; Male; Mental Disorders; Middle Aged; Reaction Time; Thiopental

The cases presented here were patients referred for neurologic disability evaluations. They met the three selection criteria presented and underwent the four-phase pentothal hypnosis procedure described and at the conclusion were diagnosed as having psychiatric morbidity. We recommend that the sodium pentothal hypnosis procedure be considered for use whenever there is concern for psychiatric co-morbidity in a patient with presumed physiologic disease.

Topics: Adult; Comorbidity; Humans; Hypnosis; Hypnotics and Sedatives; Male; Mental Disorders; Military Personnel; Thiopental; United States

During the 12-month period, 1 January 1978 to 31 December 1978, 690 people received 4,194 electroconvulsive treatments at the Psychiatric Hospital, Enugu. The diagnostic classifications of patients receiving this form of treatment included severe psychotic depression (and masked depression), catatonic schizophrenia (with marked withdrawal, mutism, or excitement); mania which has become unresponsive to major tranquilizers, some selected cases of acute delirium and the collective group "puerperal psychosis". Bilateral ECT was generally used and the frequency of treatment was two ECT's per week. The method of anaesthesia used is described and mention is made of the few and mild complications which were encountered. ECT was found to have reduced the total duration of stay in hospital (for in-patients). Considering the acute shortage of specialized manpower in the field of psychiatry in Nigeria, a suggestion is made for the establishment of community based psychiatric centres where, among other forms of therapy, ECT could be given in appropriate cases, on out-patient basis. The wider use of this form of treatment in deserving cases in psychiatric hospitals is also recommended.

Topics: Anesthesia, Intravenous; Electroconvulsive Therapy; Humans; Mental Disorders; Nigeria; Thiopental

Topics: Adult; Aged; Anesthesia, General; Arrhythmias, Cardiac; Ataxia; Atropine; Blood Pressure; Diazepam; Electrocardiography; Electroconvulsive Therapy; Electromyography; Female; Headache; Heart; Humans; Injections, Intravenous; Male; Mental Disorders; Middle Aged; Pulse; Respiration; Succinylcholine; Thiopental

Topics: Anesthesia; Anesthetics; Arrhythmias, Cardiac; Atrial Flutter; Atropine; Electric Countershock; Electric Stimulation Therapy; Electroconvulsive Therapy; Humans; Mental Disorders; Methohexital; Propanidid; Succinylcholine; Tachycardia; Thiopental; Ventricular Fibrillation

Topics: Anesthesia; Electroconvulsive Therapy; Humans; Mental Disorders; Phenylacetates; Thiopental

Topics: Amitriptyline; Humans; Injections, Intravenous; Mental Disorders; Thiopental

Topics: Chlorpromazine; Depression; Drug Therapy; Electroencephalography; Mental Disorders; Neurotic Disorders; Perphenazine; Pharmacology; Prognosis; Psychotic Disorders; Schizophrenia; Sleep; Thiopental; Thioridazine; Tranquilizing Agents

Topics: Electroencephalography; Mental Disorders; Psychotic Disorders; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, General; Barbiturates; Electroconvulsive Therapy; Humans; Mental Disorders; Pain Management; Psychiatry; Succinylcholine; Thiopental

Topics: Electroconvulsive Therapy; Humans; Mental Disorders; Seizures; Succinylcholine; Thiopental

Topics: Barbiturates; Humans; Mental Disorders; Thiopental

Topics: Barbital; Mental Disorders; Substance-Related Disorders; Thiopental

Topics: Anesthesia; Anesthesiology; Barbital; Barbiturates; Bipolar Disorder; General Surgery; Humans; Mental Disorders; Postoperative Complications; Postoperative Period; Thiopental