Pragmatic, randomised, controlled, parallel group, pilot clinical trial of ketamine vs. midazolam interleaved with electroconvulsive therapy (ECT) as an adjunctive treatment for a major depressive episode. The main purpose of the pilot study is to assess trial processes to help inform a future definitive trial.

开始日期2020-01-06

申办/合作机构

St. Patrick's University Hospital

NCT03256162 / Completed临床1期

Ketamine as an Adjunctive Therapy for Major Depression - a Randomised Controlled Pilot Trial: The KARMA-Dep Trial

Randomised, controlled, parallel-group, pilot clinical trial of ketamine vs. midazolam as an adjunctive therapy for depression. The main purpose of the pilot study is to assess trial processes to help inform a future definitive trial.

开始日期2017-09-07

申办/合作机构

St. Patrick's University Hospital

NCT03396887 / Unknown statusN/A

The Effectiveness of a Smartphone Application in the Treatment of Alcohol Use Disorder

Alcohol dependence poses a major problem for Irish and UK society, placing a huge burden on the health system. It is difficult to treat and relapse is common. There is an urgent need to develop novel treatment methods. One growing area of intervention is the use of mobile phone technology to develop personalised, patient-centred treatments. These can be used in outpatient settings, allowing patients to manage their own illness and take control of their recovery. In this study the investigators will investigate how a smartphone application, UControlDrink, can help alcoholics stay abstinent from alcohol. The application consists of a number of features known to aid recovery such as supportive messages and online therapy.

开始日期2017-05-01

申办/合作机构

St. Patrick's University Hospital

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2020·Journal of ECT

Immediate Impact of Coronavirus Disease 2019 on Electroconvulsive Therapy Practice

作者: Colbert, Sally-Anne ; McCarron, Shane ; Ryan, Geraldine ; McLoughlin, Declan M.

We are currently in the early stages of a global pandemic of coronavirus disease 2019 (COVID-19) that will last many months and challenge public health services with major socioeconomic consequences. A key component in mitigating the risk of exposure to healthcare workers is the use of personal protective equipment to prevent depletion of the health care workforce, and reduce community spread of COVID-19. This risk applies to electroconvulsive therapy (ECT) practitioners as well, because ECT involves anesthesia and noninvasive ventilation. The COVID pandemic is a rapidly evolving situation, and ECT practitioners need to keep abreast of developments and changing policies.

2016-11-15·Journal of Affective Disorders2区 · 医学

Alteration of immune markers in a group of melancholic depressed patients and their response to electroconvulsive therapy

2区 · 医学

Article

作者: Rush, Gavin ; O'Donovan, Aoife ; Nagle, Laura ; Conway, Catherine ; McCrohan, AnnMaria ; O'Farrelly, Cliona ; Lucey, James V. ; Malone, Kevin M.

BACKGROUND:

Immune system dysfunction is implicated in the pathophysiology of major depression, and is hypothesized to normalize with successful treatment. We aimed to investigate immune dysfunction in melancholic depression and its response to ECT.

METHODS:

55 melancholic depressed patients and 26 controls participated. 33 patients (60%) were referred for ECT. Blood samples were taken at baseline, one hour after the first ECT session, and 48h after ECT series completion.

RESULTS:

At baseline, melancholic depressed patients had significantly higher levels of the pro-inflammatory cytokine IL-6, and lower levels of the regulatory cytokine TGF-β than controls. A significant surge in IL-6 levels was observed one hour after the first ECT session, but neither IL-6 nor TGF-β levels normalized after completion of ECT series. Seventy per cent (n=23) of ECT recipients showed clinical response and 42% (n=10) reached remission. Neither IL-6 nor TGF-β changes correlated with clinical improvement following ECT. No significant changes in IL-10, TNF-α and CRP levels were found in relation to melancholia or response to ECT.

LIMITATIONS:

As a naturalistic study, some potential confounders could not be eliminated or controlled, including medication use.

CONCLUSIONS:

Melancholic depressed patients demonstrated a peripheral increase in IL-6 and reduction in TGF-β, which did not normalize despite clinical response to ECT. These findings may be consistent with emerging hypotheses of the role of inflammation in mediating neurotrophin expression. The implications of chronic inflammation in the melancholic depressed population for future medical health, particularly cardiovascular risk, are largely unknown and warrant further investigation.