Influence OF Bilateral Electroconvulsive Therapy Upon Some Serum Electrolytes In Some Psychiatric Patients

SUMMARY CONCLUSIONThis study was carried out to investigate the possible abnormalities in some serum electrolytes (K, Ca and Mg) that may proceed and accompany ECT in depression, mania and schizophrenia.The identification of biological changes after ECT and its correlation with clinical outcome possibly would provide clues about the controversial mode of action of this treatment.The material of the study included 60 patients who are selected and diagnosed according to DSM – IV – TR (20 schizophrenic, 20 manic, and 20 depressed).They were subjected to:1- General medical examination.2- Full clinical psychiatric study.3- Laboratory investigations including serum electrolytes before the 1st ECT session, after 3rd ECT and after 6th ECT.All results are tabulated and statistically evaluated and discussed in light of the previous Literature.From our study we reached to the following conclusions:There was increase in serum potassium concentration after ECT sessions. It can be explained by the synchronous muscle contraction of all voluntary muscles of the body after ECT, which causes the muscle venous blood which is rich in potassium to be pumped out at once into the general circulation.Serum calcium concentration after ECT showed marked decrease. This report needs further exploration, employing both balance and kinetic studies of possible mechanisms because of the observed changes in diet and physical activity accompanying depression.There is a speculative possibility that the decrease in calcium may influence release of biogenic amines from the brain, thus alleviating psychiatric disorders. However, whether changes in serum ca cone. brought about by ECT is the cause at the effect to the process of recovery from these disorders, deserves further study.Serum magnesium concentration found to be lower in depressed patients than in manic and schizophrenic patients before electroconvulsive therapy. However, serum magnesium level elevated significantly after ECT treatment. This may be explained by that since ionized magnesium isthe physiologically active portion of magnesium, it seems that magnesium is involved in the pathophysiology of these disorders especially in depression. So that after treatment with 6 sessions of electroconvulsive therapy when the patients begin to improve clinically serum magnesium level begins to be elevated.