Little John D, Munday Jo, Lyall Gordon, Greene Dennis, Chubb Graeme, Orr Michelle
Gampians Psychiatric Services, Ballarat, Victoria, Australia.
Aust N Z J Psychiatry. 2003 Dec;37(6):715-9. doi: 10.1080/j.1440-1614.2003.01262.x.
To examine the clinical practice of right unilateral electroconvulsive therapy (ECT) administered at six times seizure threshold (6 x RUL ECT).
A retrospective review of all patients who received 6 x RUL ECT between July 2000 and June 2002.
Twenty-one patients across a range of ages and diagnostic groups received D'Elia unilateral ECT at a seizure dosage at or above 388.8 milliCoumbs (mC). In order to sustain predetermined criteria for seizure adequacy, energy was increased in 71% of patients. Final seizure lengths of 45 s electroencephalographic (EEG) activity, 28 s motor activity (cuffed) and a post-ictal suppression index (PSI) of 83% were recorded. Eighty percent of patients responded after a mean of 7.0 treatments. Cognitive side-effects were noted in 21% of patients. Fifty-two percent relapsed on average 6.3 months after the last treatment despite continuation pharmacotherapy.
6 x RUL ECT was found to be clinically effective, associated with cognitive side-effects and relapse. The debate over electrode placement is likely to continue.
研究以六倍癫痫发作阈值进行右侧单侧电休克治疗（6xRUL ECT）的临床实践。
回顾性分析2000年7月至2002年6月期间接受6xRUL ECT治疗的所有患者。
21名不同年龄和诊断组的患者接受了癫痫发作剂量等于或高于388.8毫库仑（mC）的德利亚单侧ECT治疗。为了维持癫痫发作充分性的预定标准，71%的患者增加了能量。记录到脑电图（EEG）活动的最终癫痫发作时长为45秒，运动活动（使用袖带）为28秒，发作后抑制指数（PSI）为83%。80%的患者在平均接受7.0次治疗后有反应。21%的患者出现认知副作用。尽管持续进行药物治疗，但平均有52%的患者在最后一次治疗后6.3个月复发。
发现6xRUL ECT临床有效，但伴有认知副作用和复发。关于电极放置的争论可能会继续。
