{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T10:47:12Z","timestamp":1761821232455},"reference-count":21,"publisher":"Royal College of Psychiatrists","issue":"559","license":[{"start":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T00:00:00Z","timestamp":1517184000000},"content-version":"unspecified","delay-in-days":16678,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[1972,6]]},"abstract":"<jats:p>The renewed use of modified forms of narcosis, generally given together with ECT and antidepressant drugs, arose from a series of observations made during attempts to treat a group of chronically tense patients. These patients, the majority of whom had been diagnosed as \u2018chronic tension states', had been referred to the Department of Psychological Medicine at St. Thomas' Hospital for assessment regarding their suitability for modified leucotomy. Birley (1964), in a follow-up study of previous patients with \u2018tension states' treated by leucotomy at St. Thomas' Hospital, had found that many developed clear-cut attacks of depression following the operation. This suggested to one of us (W.S.) that such \u2018tension states' might have been masked depressive illnesses, in whom the underlying diagnosis had been missed. Consequently it was decided that in the future such patients should be treated with suitably long courses of ECT, together with one or both groups of antidepressant drugs, before any question of recommending leucotomy arose. As a result, a considerable number of these patients were greatly improved and no longer required a leucotomy. Others, however, became more tense and distressed during treatment with ECT and drugs; modified narcosis, therefore, was given in addition, to allow the full course of ECT to be completed. It was then that another of us (C.W.) observed that patients who were treated with combined narcosis, ECT and antidepressants appeared to respond more favourably, and were much less upset by the treatment, than those receiving ECT and antidepressants alone. In a preliminary report published in 1966, Sargant, Walter and Wright described a group of 73 patients with \u2018chronic tension states', of whom 67 per cent had improved markedly with further treatment of their underlying depression. It was noted that 15 of the 37 patients treated with ECT and antidepressants alone still required a leucotomy, while in the group treated with modified narcosis in addition to ECT and antidepressants the operation was needed in only 3 of the 36 patients. It appeared, therefore, that the addition of narcosis to drugs and ECT greatly improved the recovery rate.<\/jats:p>","DOI":"10.1192\/bjp.120.559.651","type":"journal-article","created":{"date-parts":[[2008,8,12]],"date-time":"2008-08-12T22:35:43Z","timestamp":1218580543000},"page":"651-662","source":"Crossref","is-referenced-by-count":14,"title":["Modified Narcosis, ECT and Antidepressant Drugs: A Review of Technique and Immediate Outcome"],"prefix":"10.1192","volume":"120","author":[{"given":"C. J. S.","family":"Walter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita","family":"Mitchell-Heggs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Sargant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2018,1,29]]},"reference":[{"key":"S0007125000197521_ref20","article-title":"\u2018Clinical significance of plasma imipramine levels.\u2019","volume":"64","author":"Walter","year":"1971","journal-title":"Proceedings of the Royal Society of Medicine"},{"key":"S0007125000197521_ref14","article-title":"\u2018The bromide sleep: A new departure in the treatment of acute mania.\u2019","volume":"1","author":"McLeod","year":"1900","journal-title":"British Medical Journal"},{"key":"S0007125000197521_ref2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.110.465.211"},{"key":"S0007125000197521_ref12","volume-title":"Le Sommeil Provoqu\u00e9 et les \u00c9tats Analogues.","author":"Li\u00e9bault","year":"1866"},{"key":"S0007125000197521_ref16","article-title":"\u2018Prolonged narcosis as therapy in the psychoses.\u2019","volume":"12","author":"Palmer","year":"1932","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000197521_ref17","volume-title":"An Introduction to Physical Methods of Treatment in Psychiatry.","author":"Sargant","year":"1944"},{"key":"S0007125000197521_ref10","article-title":"\u2018Uber Somnifen, eine medikamentose Therapie schizophrener Aufregungszustande.\u2019","volume":"8","author":"Kl\u00e4si","year":"1921","journal-title":"Schweizer Archiv f\u00fcr Neurologic und Psychiatrie"},{"key":"S0007125000197521_ref3","article-title":"\u2018Continuous sleep treatment.\u2019","volume":"106","author":"Clapp","year":"1950","journal-title":"American Journal of Psychiatry"},{"key":"S0007125000197521_ref18","article-title":"\u2018New treatment of some chronic tension states.\u2019","volume":"i","author":"Sargant","year":"1966","journal-title":"British Medical Journal"},{"key":"S0007125000197521_ref9","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.115.521.401"},{"key":"S0007125000197521_ref7","volume-title":"Mental Pathology and Therapeutics.","author":"Griesinger","year":"1861"},{"key":"S0007125000197521_ref4","volume-title":"Clinical Lectures on Mental Diseases.","author":"Clouston","year":"1883"},{"key":"S0007125000197521_ref1","article-title":"\u2018Insulin treatment of schizophrenia: a controlled study.\u2019","volume":"i","author":"Ackner","year":"1957","journal-title":"Lancet"},{"key":"S0007125000197521_ref5","first-page":"1","article-title":"\u2018Sleep therapy and the use of chlorpromazine.\u2019","volume":"170","author":"Ey","year":"1957","journal-title":"International Record of Medicine"},{"key":"S0007125000197521_ref6","article-title":"\u2018Treatment of depressive illnesses with combined antidepressants.\u2019","volume":"ii","author":"Gander","year":"1965","journal-title":"Lancet"},{"key":"S0007125000197521_ref21","volume-title":"Sleep Therapy.","author":"Williams","year":"1966"},{"key":"S0007125000197521_ref8","article-title":"\u2018Chemical control of antidepressant drug therapy.\u2019","volume":"122","author":"Hammer","year":"1967","journal-title":"Excerpta Medica (Amsterdam). International Congress Series No."},{"key":"S0007125000197521_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/BF02869781"},{"key":"S0007125000197521_ref13","article-title":"\u2018Die Dauernarkose mit Somnifen in der Psychiatrie.\u2019","volume":"96","author":"M\u00f6ller","year":"1925","journal-title":"Zeitschrift f\u00fcr die gesamte Neurologie und Psychiatrie"},{"key":"S0007125000197521_ref15","doi-asserted-by":"crossref","DOI":"10.1192\/bjp.83.347.636","article-title":"\u2018The value of continuous narcosis in the treatment of mental disorder.\u2019","volume":"83","author":"Palmer","year":"1937","journal-title":"Journal of Mental Science"},{"key":"S0007125000197521_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/BF02881914"}],"container-title":["British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125000197521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T21:12:00Z","timestamp":1559250720000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125000197521\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1972,6]]},"references-count":21,"journal-issue":{"issue":"559","published-print":{"date-parts":[[1972,6]]}},"alternative-id":["S0007125000197521"],"URL":"https:\/\/doi.org\/10.1192\/bjp.120.559.651","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[1972,6]]}}}