Girish Kunigiri

• Leicestershire Partnership NHS Trust

Electroconvulsive therapy (ECT) is widely used in most countries in Asia. There are several regards in which the practice of ECT in this region deviate from the guidelines issued by the American Psychiatric Association and the Royal College of Psychiatrists. The deviations are a matter of concern but are not surprising, considering that most previo...

To describe a comprehensive survey of the practice of electroconvulsive therapy (ECT) in Asia. Between 2001 and 2003, a 29-item questionnaire was sent to 977 psychiatric facilities in 45 Asian countries. Completed questionnaires were returned by 334 (34.2%) institutions in 29 (64.4%) countries. Electroconvulsive therapy was available in 257 institu...

Although electroconvulsive therapy (ECT) causes no structural brain damage, recent studies reported altered brain perfusion acutely following ECT. This is in keeping with brain edema which was noted in animal experiments following electroconvulsive shock. This study examined alteration in magnetic resonance imaging (MRI) T(2) relaxation time, a mea...

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We sought to obtain an overview of electroconvulsive therapy (ECT) practice in teaching hospitals in India. From September 1, 2001, to August 31, 2002, a 29-item questionnaire enquiring about ECT practice during the past year was sent to 188 teaching institutions and psychiatric hospitals. Seventy-four institutions (39.4%) completed the questionnai...

This study examined the effect of low- and high-pulse frequency stimulus electroconvulsive therapy on seizure physiology and therapeutic outcome. Forty depressed patients randomly received either low (n = 19) or high (n = 21) pulse frequency stimulus during a course of right unilateral electroconvulsive therapy. The current and pulse width were kep...

Measures of EEG during ECT, for example, smaller post-seizure fractal dimension have predicted antidepressant response. The earlier study on this subject used bilateral ECT. This study aims to examine if this finding holds good even for unilateral ECT, using both fractal dimension and spectral power analysis of EEG. The objective of the study was t...

Stimulus parameters, such as pulse width, frequency, and stimulus train duration, affect seizure threshold in electroconvulsive therapy (ECT), although variably. This study examined the effect of low- and high-pulse frequencies of stimulus on seizure threshold and physiological responses to ECT. Twenty-four consenting inpatients prescribed ECT by t...

To compare the efficacy of electroconvulsive therapy (ECT) with risperidone in the treatment of lorazepam non-responsive catatonia. Inpatients with non-affective catatonia (n= 18) non-responsive to at least five-day trial of lorazepam (6-8 mg/day) were randomised into two groups in a double blind randomised design. Written informed consent was obta...

This study examined the concurrent use of psychotropic drugs on seizure duration during Electroconvulsive therapy (ECT). Consecutive consenting patients prescribed bilateral ECT (n=182) by the treating psychiatrist were considered for the study. The concurrent psychotropic medication (antipsychotic, antidepressant, benzodiazepine and lithium) was r...

It is a myth that electroconvulsive therapy (ECT) produces greater side effects and worsens the neurological condition when used in neurologically ill patients. With the advancement and sophistication in ECT practice standards and modification procedures, it can be safely administered either to treat selected neurological conditions or the co-morbi...

Eliciting cerebral seizure during electroconvulsive therapy (ECT) is essential for therapeutic purposes. When it exceeds beyond 120 seconds (Freeman, 1995) i.e., prolonged, it adds to adverse effects of ECT. Estimating seizure duration using 'cuff method' alone has limitations. This study examined the merits of electroencephalographic (EEG) monitor...

During electroconvulsive therapy (ECT), occurrence of seizure must be confirmed. Cuff method, although simple and reliable, can sometimes miss an adequate EEG seizure. Predictable cardiovascular response occurs during ECT seizure. We examined if this can be an additional guide to detect cerebral seizure. In 164 modified ECT sessions, EEG and cuff m...

The aim of the study was to detect brain oedema with electroconvulsive therapy (ECT). Magnetic resonance imaging (MRI) T(2) relaxation time which is an indicator of brain water was measured one day prior to the first ECT and at two hours after second ECT in five depressive patients prescribed right unilateral (RUL) ECT. MRI T(2), relaxation time wa...

Formula methods of estimating seizure threshold in bilateral electroconvulsive therapy (ECT) have been successful in 75% (at the first ECT) and 80% (at the sixth ECT) of treatments (Gangadhar et al., 1998). This study showed the same results for unilateral (UL) ECT patients. Its aim was to compare formula and titration methods for threshold determi...

Electroconvulsive therapy (ECT) is used to induce therapeutic seizures in various clinical conditions. It is specifically useful in depression, catatonia, patients with high suicidal risk, and those intolerant to drugs. Its beneficial effects surpass its side effects. Memory impairment is benign and transient. Its mechanism of action is unknown, th...

Seizure thresholds were determined by titration in consecutive electroconvulsive therapy (ECT) patients at the first (n = 146) and sixth (N = 83) ECT sessions. Equations to predict the threshold at the first and sixth ECT were computed from these data using a stepwise linear regression model. These equations were tested prospectively at the first E...

Research on determinants of ECT seizure threshold is inadequate. In view of differences in ECT populations and confounding factors, there is a need for examining this in our population. Consecutive consenting inpatients (N=100), referred for bilateral (BL) ECT by treating psychiatrists at National Institute of Mental Health and Neuro Sciences Hospi...

The effect of electrode placement on cardiovascular responses was studied. Rate pressure product and diastolic blood pressure before anesthesia and 30 s after electroconvulsive therapy (ECT) seizure were recorded. Recordings were made at the first (threshold ECT) session in 124 bilateral ECT (BLECT) and 95 unilateral ECT (ULECT) consenting patients...

Several factors such as age, gender, medication status, head measurements and stimulus laterality are known to influence seizure threshold in ECT. Determinants of high (greater than or equal to median stimulus dose) or low (< median stimulus dose) threshold were identified using discriminant function analysis. Separate analysis was conducted on uni...