title: Safety of electroconvulsive therapy in psychiatric patients shortly after the occurrence of pulmonary embolism.
abstract: We encountered 2 patients with a psychiatric disorder (depression in one and catatonia in one) accompanied by motor inhibition that was complicated by pulmonary embolism (PE). In both cases, the psychiatric disorder was safely resolved with electroconvulsive therapy (ECT) during anticoagulant therapy. The 2 cases direct our attention to at least 3 important points regarding safe administration of ECT shortly after the occurrence of PE, that is, careful evaluation of cardiac function and residual deep vein thrombosis before the start of an ECT course, adjustment of anticoagulants, and prevention of recurrent deep vein thrombosis and PE by methods in addition to anticoagulant therapy (fluid infusion, use of support hose, and timely ECT).
authors.affiliation: Department of Psychiatry, Tohoku University Hospital, Sendai, Japan. kazumasa-tohoku@umin.ac.jp
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kousei
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Takehisa
authors.initials: T
authors.lastname: Takano
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Ko
authors.initials: K
authors.lastname: Fujiyama
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsuoka
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002389:Catatonia / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D005440:Fluid Therapy; D006334:Heart Function Tests; D006801:Humans; D006998:Hypochondriasis / Q000523:psychology / Q000628:therapy; D020347:Lithiasis / Q000150:complications; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000188:drug therapy; D000069348:Quetiapine Fumarate; D012008:Recurrence; D020246:Venous Thrombosis / Q000150:complications / Q000628:therapy
chemical_list: D000925:Anticoagulants; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate