73 Both methods can reduce the switch risk significantly. twice cognitive side effects All patients are confused on awakening after a seizure. The duration and the severity of the post-seizure delirium

vary with patient age (older patients have more severe and more prolonged periods of confusion), dosage and type of anesthetic, and the characteristics of the medications, both psychoactive and systemic, which may be prescribed for the patients. Special attention is paid to sedatives and anxiolytics, antipsychotics, and lithium that may Inhibitors,research,lifescience,medical augment the confusional syndrome. Typical side effects which are more prominent in bilateral than in unilateral and in high-dose than in lower dose ECT4 are transient cognitive disturbances. Inhibitors,research,lifescience,medical ‘ITttese include short-term memory disturbances in up to 30% of the treated patients.124 Postictal delirium including

a. prolonged reorientation period and memory disturbances including anterograde or retrograde amnesia can be differentiated from rarely occurring effects on the autobiographic long-term memory.125 In addition, cognitive deficits not. emerging from memory disturbances, such as concentration or attention deficits, can occur. It. can be difficult, in an individual patient to differentiate the cognitive side effects of an ECT treatment from cognitive disturbances caused by Inhibitors,research,lifescience,medical depression itself.126 Therefore a variety of patients

report amelioration of cognitive impairment after an Inhibitors,research,lifescience,medical ECT treatment course.127 As described, the rate of cognitive disturbances is dependent, on dose and application of electrical stimulation.85,127 Sometimes patients experience profound and sustained memory loss, sufficient, to interfere with their ability to return to work. Such instances are rare, but. are the principal burden of the complaints against, the use of ECT.2,41 Nevertheless, recent improvements in the use of ECT include methods to maintain good therapeutic efficacy together with a better tolerability Brefeldin_A concerning Inhibitors,research,lifescience,medical cognitive disturbances. Using modified ECT techniques,128 including unilateral or bifrontal pulse wave stimulation, anesthesia with inhibitor manufacture muscle relaxation, and sufficient, oxygenation, these risks could be reduced substantially.64,68,128 If, in spite of these precautions, cognitive disturbances occur, a rapid improvement, within 1 and up to 4 weeks can be observed in most cases.128 Follow-up investigations showed a. complete reversibility of cognitive side effects after an ECT course128,129 or even an improvement in comparison with the time interval before ECT treatment.3,129 A variety of case reports, case series, and controlled studies confirm that. ECT does not cause long-lasting functional54 or any structural damage of the central nervous system.