Electroconvulsive therapy in @entity2437 XXXX : Efficacy and predictors of response.

@entity1 @entity3326 @entity162 @entity1316 @entity1245 @entity51 @entity4148 @entity716 @entity6406 @entity21 @entity2436 @entity2437 @entity1155
Recent evidence favors the view of @entity2436 as an @entity4148 , frequently associated with @entity1316 , but also observed in neurological, neurodevelopmental, physical and toxic conditions. From our systematic literature review, electroconvulsive therapy (ECT) results effective in all forms of @entity2436 , even after pharmacotherapy with @entity1245 has failed. Response rate ranges from 80% to 100% and results superior to those of any other therapy in psychiatry. ECT should be considered first-line treatment in @entity1 with malignant @entity2436 , @entity3326 , @entity162 or severe @entity2437 excitement, and in general in all @entity2437 @entity1 that are refractory or partially responsive to @entity1245 . Early intervention with ECT is encouraged to avoid undue deterioration of the @entity1 's medical condition. Little is known about the long-term treatment outcomes following administration of ECT for @entity2436 . The presence of a concomitant chronic neurologic disease or @entity21 seems to be related to ECT non-response. On the contrary, the presence of acute, severe and @entity6406 is associated with good response. Severe @entity716 features in responders may be related with a prominent GABAergic mediated @entity51 , whereas non-responders may be characterized by a prevalent dopaminergic mediated @entity21 . These observations are consistent with the hypothesis that ECT is more effective in "top-down" variant of @entity2436 , in which the @entity1155 may be sustained by a dysregulation of the orbitofrontal cortex, than in "bottom-up" variant, in which an @entity21 may be prevalent. Future research should focus on ECT response in different subtype of @entity2436 and on efficacy of maintenance ECT in long-term prevention of recurrent @entity2436 . Further research on mechanism of action of ECT in @entity2436 may also contribute to the development of other brain stimulation techniques.
