ECT--OPTIMUM SCHEDULE AND ANTIDEPRESSANT MECHANISMS

ECT--最佳时间表和抗抑郁机制

• 批准号: 2248161
• 负责人: BERNARD LERER
• 金额: $ 2.87万
• 依托单位: HADASSAH-HEBREW UNIVERSITY MEDICAL CTR
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1995-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2248161
• 关键词: adrenocorticotropic hormone; antidepressants; corticotropin releasing factor; cortisol; dosage; drug interactions; electroconvulsive therapy; fenfluramine; human subject; human therapy evaluation; major depression; memory; neurochemistry; neuropharmacology; neuropsychological tests; serotonin receptor

DESCRIPTION (Adapted from Applicant's Abstract): Although electroconvulsive therapy (ECT) is recognized to be highly effective and is extensively used in the management of severe depression, an optimum treatment schedule has never been definitively established. Clinical practice continues to vary widely in terms of frequency of administration and number of ECTs in the series. Interim results from the present project confirm that these parameters can substantially influence both rate of antidepressant response and cognitive adverse effects. Compared to twice weekly treatment (ECTx2), patients who received ECTx3 per week responded significantly more rapidly but were also more impaired on neuropsychological testing at the end of the four week trial (although not at 1 and 6 month follow-up). The next stage of the project will focus on optimization of the more rapidly effective ECTx3 schedule by reducing the number of ECT's administered to this group. This strategy is justified by the previous findings and is expected to significantly diminish cognitive morbidity without altering rate of response or final outcome. Double-blind comparison with ECTx2 will be achieved by the use of simulated ECT and the groups will be balanced in terms of number of real (n=8) and simulated (n=4) treatments administered during the 4 week acute phase of the study. Long term effects will again be assessed during 6 month follow-up under lithium carbonate continuation therapy. A central objective of the project has been to correlate biological effects of ECT with optimally effective treatment. The next phase of the study will further characterize the significant enhancement by ECT of serotonergically mediated hormone release which was previously demonstrated. The time course and long term status of this effect will be examined and specific neurochemical components identified by the introduction of an additional pharmaco-endocrine (fenfluramine or ipsapirone) challenge paradigm.

描述（改编自申请人的摘要）：虽然 电休克疗法（ECT）被认为是非常有效的， 广泛用于严重抑郁症的管理， 治疗时间表从未确定。 临床 就给药频率而言， 和系列中的ECT数量。 本项目的中期成果 确认这些参数可以显著影响 抗抑郁反应和认知不良反应。 相比之下， 每周一次治疗（ECTx2），每周接受ECTx3的患者有应答 但也更容易受损， 在四周试验结束时进行神经心理学测试（尽管没有 在1个月和6个月随访时）。 项目的下一阶段将集中在优化的更多 通过减少ECT的数量快速有效的ECTx3时间表 给这个群体。 这一战略是合理的， 研究结果，并预计将显着降低认知发病率 而不改变反应率或最终结果。 双盲 与ECTx2的比较将通过使用模拟ECT和 各组将在真实的（n=8）和模拟的数量方面保持平衡 （n=4）在研究的4周急性期期间施用的治疗。 将在6个月随访期间再次评估长期影响， 碳酸锂持续治疗。 该项目的一个中心目标是将生物效应 ECT的最佳有效治疗。 研究的下一阶段 将进一步表征ECT的显著增强， 促肾上腺皮质激素介导的激素释放， 演示。 这种影响的时间过程和长期状态将是 检查和特定的神经化学成分确定的 引入额外的药物内分泌（芬氟拉明或 ipsapirone）挑战范例。

项目成果

Speed of response to bilateral ECT: an examination of possible predictors in two controlled trials.

双侧 ECT 的反应速度：在两项对照试验中检查可能的预测因素。

• 发表时间: 1999
• 期刊: The journal of ECT.
• 作者: Shapira,B;Lerer,B
• 通讯作者: Lerer,B

Onset and time course of antidepressant action: psychopharmacological implications of a controlled trial of electroconvulsive therapy.

抗抑郁作用的起效和时程：电惊厥治疗对照试验的精神药理学意义。

• DOI: 10.1007/bf02245860
• 发表时间: 1995
• 期刊: Psychopharmacology
• 影响因子: 3.4
• 作者: Segman,RH;Shapira,B;Gorfine,M;Lerer,B
• 通讯作者: Lerer,B

Prolactin response to fenfluramine and placebo challenge following maintenance pharmacotherapy withdrawal in remitted depressed patients.

缓解抑郁症患者维持药物治疗停药后催乳素对芬氟拉明和安慰剂挑战的反应。

• DOI: 10.1016/0006-3223(93)90008-2
• 发表时间: 1993
• 期刊: Biological psychiatry
• 影响因子: 10.6
• 作者: Shapira,B;Cohen,J;Newman,ME;Lerer,B
• 通讯作者: Lerer,B

Antidepressant and cognitive effects of twice- versus three-times-weekly ECT.

• DOI: 10.1176/ajp.152.4.564
• 发表时间: 1995-04
• 期刊: The American journal of psychiatry
• 作者: B. Lerer;B. Shapira;A. Calev;N. Tubi;H. Drexler;S. Kindler;D. Lidsky;Joseph E. Schwartz

Cost and benefit in the choice of ECT schedule. Twice versus three times weekly ECT.

选择 ECT 时间表的成本和收益。

• DOI: 10.1192/bjp.172.1.44
• 发表时间: 1998
• 期刊: The British journal of psychiatry : the journal of mental science
• 作者: Shapira,B;Tubi,N;Drexler,H;Lidsky,D;Calev,A;Lerer,B
• 通讯作者: Lerer,B