Is Electroconvulsive Therapy a Treatment for Depression Following Traumatic Brain Injury?

Innovations in Clinical Neuroscience

Steven Lippmann¹  Puneet Narang²  Simrat Sarai³  Anja Srienc⁴  Yee Xiong⁵ 

[1] Dr. Lippmann is Professor of Psychiatry at the University of Louisville School of Medicine in Louisville, Kentucky.;Dr. Narang is Assistant Professor at the University of Minnesota, and Staff Physician, Lead ECT Psychiatrist at the Regions Hospital in Minneapolis-St. Paul, Minnesota.;Dr. Sarai is Research Scholar at the University of Louisville School of Medicine in Louisville, Kentucky.;Dr. Srienc is with the Medical Scientist Training Program Graduate Program in Neuroscience at the University of Minnesota in Minneapolis-St. Paul, Minnesota.;Dr. Xiong is Psychiatry Resident, HCMC-Regions Psychiatry Residency Program in Minneapolis, Minnesota.

关键词: Traumatic brain injury;    TBI;    mood disorders;    depression;    treatments;    electroconvulsive therapy;    ECT;   

DOI  :  

学科分类：精神健康和精神病学

来源: Matrix Medical Communications, LLC

【 摘 要 】

Traumatic brain injury (TBI) can be caused by blunt or penetrating injury to the head. The pathophysiological evolution of TBI involves complex biochemical and genetic changes. Common sequelae of TBI include seizures and psychiatric disorders, particularly depression. In considering pharmacologic interventions for treating post-TBI depression, it is important to remember that TBI patients have a higher risk of seizures; therefore, the benefits of prescribing medications that lower the seizure threshold need to be weighed against the risk of seizures. When post-TBI depression is refractory to pharmacotherapy, electroconvulsive therapy (ECT) could provide an alternative therapeutic strategy. Data remain sparse on using ECT in this seizure-prone population, but three case reports demonstrated good outcomes. Currently, not enough evidence exists to provide clinical recommendations for using ECT for treating post-TBI depression, and more research is needed to generate guidelines on how best to treat depression in TBI patients. However, the preliminary data on using ECT in patients with TBI are promising. If proven safe, ECT could be a powerful tool to treat post-TBI depression.

【 授权许可】

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