{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:58:07Z","timestamp":1780991887987,"version":"3.54.1"},"reference-count":20,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"4","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>This study assessed the use, tolerability, and safety of anticoagulation via direct oral anticoagulants or warfarin in medical and psychiatric inpatients receiving ECT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study included 32 patients who received ECT while on either a direct oral anticoagulant (9) or warfarin (23) and spanned 247 encounters at Maine Medical Center between December 2012 and December 2018. Data are presented descriptively and analyzed using SPSS version 25 and Microsoft Excel version 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 247 ECT patient encounters, there were few major adverse effects of ECT in this medically complex population. These adverse effects included headache during 4 encounters (1.6%), respiratory distress during 2 encounters (0.8%) and a cardiovascular event during 1 encounter (0.4%). One patient (3.1%) who was receiving concurrent rivaroxaban and venlafaxine experienced gastrointestinal bleeding that was determined to be unrelated to ECT. One patient on fluoxetine and warfarin experienced hemoptysis thought to be secondary to epistaxis. No other major bleeding or clotting event occurred during an ECT session nor for the duration of the hospitalization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Direct oral anticoagulants and warfarin appear safe in the treatment of patients with atrial fibrillation or acute venous thromboembolism who are receiving concomitant ECT. Prospective studies are needed to confirm these findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.9740\/mhc.2021.07.254","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T17:41:43Z","timestamp":1626457303000},"page":"254-258","source":"Crossref","is-referenced-by-count":8,"title":["Safety of ECT in patients receiving an oral anticoagulant"],"prefix":"10.9740","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1946-2849","authenticated-orcid":true,"given":"Nicolette R.","family":"Centanni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5533-6375","authenticated-orcid":true,"given":"Wendy Y.","family":"Craig","sequence":"additional","affiliation":[{"name":"Research Navigator, Maine Medical Center Research Institute\/Center for Outcomes Research & Evaluation, Scarborough, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7598-644X","authenticated-orcid":true,"given":"Dena L.","family":"Whitesell","sequence":"additional","affiliation":[{"name":"Director, Consultation and Liaison Services, Associate Residency Training Director, Psychiatry Clerkship Director, Maine Medical Center, Portland, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5046-7966","authenticated-orcid":true,"given":"Wesley R.","family":"Zemrak","sequence":"additional","affiliation":[{"name":"Pharmacy Supervisor of Hemostasis and Thrombosis, Maine Medical Center, Portland, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-5953","authenticated-orcid":true,"given":"Stephanie D.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Associate Professor of Pharmacy, Westbrook College of Health Professions, Portland, Maine; Adjunct Clinical Assistant Professor of Psychiatry, University of New England School of Medicine, Tufts University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"2021071617405573800_i2168-9709-11-4-254-b01","doi-asserted-by":"crossref","unstructured":"Ross\n              EL,\n            \n            \n              Zivin\n              K,\n            \n            \n              Maixner\n              DF.\n            \n          \n          Cost-effectiveness of electroconvulsive therapy vs pharmacotherapy\/psychotherapy for treatment-resistant depression in the United States.\n\t\t\t\t\tJAMA Psychiatry.\n\t\t\t\t\t2018;\n\t\t\t\t\t75(7):\n\t\t\t\t\t713-\n\t\t\t\t\t22.\n\t\t\t\t\tDOI: 10.1001\/jamapsychiatry.2018.0768. PubMed PMID: 29800956; PubMed Central PMCID: PMC6145669.","DOI":"10.1001\/jamapsychiatry.2018.0768"},{"key":"2021071617405573800_i2168-9709-11-4-254-b02","doi-asserted-by":"crossref","unstructured":"Hirata\n              T,\n            \n            \n              Yasuda\n              K,\n            \n            \n              Uemura\n              T,\n            \n            \n              Ueda\n              T,\n            \n            \n              Aruga\n              Y,\n            \n            \n              Shioe\n              R,\n            \n            et al.\n          \n          Electroconvulsive therapy in patients with cerebral aneurysms taking an anticoagulant or antiplatelet\u2014report on three cases and review of the literature.\n\t\t\t\t\tPsychiatry Res.\n\t\t\t\t\t2020;\n\t\t\t\t\t288(1):\n\t\t\t\t\t113022.\n\t\t\t\t\tDOI: 10.1016\/j.psychres.2020.113022. PubMed PMID: 32335467.","DOI":"10.1016\/j.psychres.2020.113022"},{"key":"2021071617405573800_i2168-9709-11-4-254-b03","unstructured":"Petrides\n              G,\n            \n            \n              Fink\n              M.\n            \n          \n          Atrial fibrillation, anticoagulation, and electroconvulsive therapy.\n\t\t\t\t\tConvuls Ther.\n\t\t\t\t\t1996;\n\t\t\t\t\t12(2):\n\t\t\t\t\t91-\n\t\t\t\t\t8.\n\t\t\t\t\tPubMed PMID: 8744168."},{"key":"2021071617405573800_i2168-9709-11-4-254-b04","doi-asserted-by":"crossref","unstructured":"Mehta\n              V,\n            \n            \n              Mueller\n              PS,\n            \n            \n              Gonzalez-Arriaza\n              HL,\n            \n            \n              Pankratz\n              VS,\n            \n            \n              Rummans\n              TA.\n            \n          \n          Safety of electroconvulsive therapy in patients receiving long-term warfarin therapy.\n\t\t\t\t\tMayo Clin Proc.\n\t\t\t\t\t2004;\n\t\t\t\t\t79(11):\n\t\t\t\t\t1396-\n\t\t\t\t\t401.\n\t\t\t\t\tDOI: 10.4065\/79.11.1396. PubMed PMID: 15544018.","DOI":"10.4065\/79.11.1396"},{"key":"2021071617405573800_i2168-9709-11-4-254-b05","doi-asserted-by":"crossref","unstructured":"Suzuki\n              K,\n            \n            \n              Takamatsu\n              K,\n            \n            \n              Takano\n              T,\n            \n            \n              Tanabe\n              Y,\n            \n            \n              Fujiyama\n              K,\n            \n            \n              Matsuoka\n              H.\n            \n          \n          Safety of electroconvulsive therapy in psychiatric patients shortly after the occurrence of pulmonary embolism.\n\t\t\t\t\tJ ECT.\n\t\t\t\t\t2008;\n\t\t\t\t\t24(4):\n\t\t\t\t\t286-\n\t\t\t\t\t8.\n\t\t\t\t\tDOI: 10.1097\/YCT.0b013e31816c434a. PubMed PMID: 18617865.","DOI":"10.1097\/YCT.0b013e31816c434a"},{"key":"2021071617405573800_i2168-9709-11-4-254-b06","doi-asserted-by":"crossref","unstructured":"Ishida\n              T,\n            \n            \n              Sakurai\n              H,\n            \n            \n              Watanabe\n              K,\n            \n            \n              Iwashita\n              S,\n            \n            \n              Mimura\n              M,\n            \n            \n              Uchida\n              H.\n            \n          \n          Incidence of deep vein thrombosis in catatonic patients: a chart review.\n\t\t\t\t\tPsychiatry Res.\n\t\t\t\t\t2016;\n\t\t\t\t\t241(2):\n\t\t\t\t\t61-\n\t\t\t\t\t5.\n\t\t\t\t\tDOI: 10.1016\/j.psychres.2016.04.105. PubMed PMID: 27156025.","DOI":"10.1016\/j.psychres.2016.04.105"},{"key":"2021071617405573800_i2168-9709-11-4-254-b07","doi-asserted-by":"crossref","unstructured":"Hamdieh\n              M,\n            \n            \n              Safaie\n              N,\n            \n            \n              Abbasinejad\n              M.\n            \n          \n          A psychiatric patient with catatonia and pulmonary thromboemboli.\n\t\t\t\t\tJ Neurophysiol.\n\t\t\t\t\t2014;\n\t\t\t\t\t26(1):\n\t\t\t\t\tE19-\n\t\t\t\t\t20.\n\t\t\t\t\tDOI: 10.1176\/appi.neuropsych.13010004. PubMed PMID: 24515695.","DOI":"10.1176\/appi.neuropsych.13010004"},{"key":"2021071617405573800_i2168-9709-11-4-254-b08","doi-asserted-by":"crossref","unstructured":"Mamah\n              D,\n            \n            \n              Lammle\n              M,\n            \n            \n              Isenberg\n              KE.\n            \n          \n          Pulmonary embolism after ECT.\n\t\t\t\t\tJ ECT.\n\t\t\t\t\t2005;\n\t\t\t\t\t21(1):\n\t\t\t\t\t39-\n\t\t\t\t\t40.\n\t\t\t\t\tDOI: 10.1097\/01.yct.0000152572.27344.f5. PubMed PMID: 15791176.","DOI":"10.1097\/01.yct.0000152572.27344.f5"},{"key":"2021071617405573800_i2168-9709-11-4-254-b09","doi-asserted-by":"crossref","unstructured":"Hirata\n              T,\n            \n            \n              Yasuda\n              K,\n            \n            \n              Uemura\n              T,\n            \n            \n              Ohtsuki\n              M,\n            \n            \n              Kobayashi\n              K,\n            \n            \n              Ueda\n              T,\n            \n            et al.\n          \n          Electroconvulsive therapy while receiving oral anticoagulation for deep venous thrombosis: report on eight cases and a review of the literature.\n\t\t\t\t\tPsychosomatics.\n\t\t\t\t\t2019;\n\t\t\t\t\t60(4):\n\t\t\t\t\t402-\n\t\t\t\t\t9.\n\t\t\t\t\tDOI: 10.1016\/j.psym.2018.10.007. PubMed PMID: 30503364.","DOI":"10.1016\/j.psym.2018.10.007"},{"key":"2021071617405573800_i2168-9709-11-4-254-b10","doi-asserted-by":"crossref","unstructured":"Singh\n              G,\n            \n            \n              Wahi\n              S.\n            \n          \n          Pulmonary embolism in the ECT patient: a case report and discussion.\n\t\t\t\t\tGen Hosp Psychiatry.\n\t\t\t\t\t2008;\n\t\t\t\t\t30(1):\n\t\t\t\t\t87-\n\t\t\t\t\t9.\n\t\t\t\t\tDOI: 10.1016\/j.genhosppsych.2007.08.009. PubMed PMID: 18164948.","DOI":"10.1016\/j.genhosppsych.2007.08.009"},{"key":"2021071617405573800_i2168-9709-11-4-254-b11","doi-asserted-by":"crossref","unstructured":"Dean\n              J\n            \n            \n              Coconcea\n              C.\n            \n          \n          Electroconvulsive therapy in a patient with pulmonary embolism.\n\t\t\t\t\tJ ECT.\n\t\t\t\t\t2016;\n\t\t\t\t\t32(3):\n\t\t\t\t\te12.\n\t\t\t\t\tDOI: 10.1097\/YCT.0000000000000311. PubMed PMID: 26934276.","DOI":"10.1097\/YCT.0000000000000311"},{"key":"2021071617405573800_i2168-9709-11-4-254-b12","doi-asserted-by":"crossref","unstructured":"Inagawa\n              Y,\n            \n            \n              Saito\n              S,\n            \n            \n              Okada\n              T,\n            \n            \n              Inoue\n              K,\n            \n            \n              Suda\n              S.\n            \n          \n          Electroconvulsive therapy for catatonia with deep venous thrombosis.\n\t\t\t\t\tPrim Care Companion CNS Disord.2018;\n\t\t\t\t\t20(4):\n\t\t\t\t\t18m02286.DOI: 10.4088\/PCC.18m02286. PubMed PMID: 29995361.","DOI":"10.4088\/PCC.18m02286"},{"key":"2021071617405573800_i2168-9709-11-4-254-b13","doi-asserted-by":"crossref","unstructured":"Chai-Adisaksopha\n              C,\n            \n            \n              Crowther\n              M,\n            \n            \n              Isayama\n              T,\n            \n            \n              Lim\n              W.\n            \n          \n          The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis.\n\t\t\t\t\tBlood.\n\t\t\t\t\t2014;\n\t\t\t\t\t124(15):\n\t\t\t\t\t2450-\n\t\t\t\t\t8.\n\t\t\t\t\tDOI: 10.1182\/blood-2014-07-5990232.PubMed PMID: 25150296.","DOI":"10.1182\/blood-2014-07-590323"},{"key":"2021071617405573800_i2168-9709-11-4-254-b14","doi-asserted-by":"crossref","unstructured":"Shuman\n              M,\n            \n            \n              Hieber\n              R,\n            \n            \n              Moss\n              L,\n            \n            \n              Patel\n              D.\n            \n          \n          Rivaroxaban for thromboprophylaxis in a patient receiving electroconvulsive therapy.\n\t\t\t\t\tJ ECT.\n\t\t\t\t\t2015;\n\t\t\t\t\t31(1):\n\t\t\t\t\te19-\n\t\t\t\t\t20.\n\t\t\t\t\tDOI: 10.1097\/YCT.0000000000000206. PubMed PMID: 25587812.","DOI":"10.1097\/YCT.0000000000000206"},{"key":"2021071617405573800_i2168-9709-11-4-254-b15","doi-asserted-by":"crossref","unstructured":"Shao\n              E,\n            \n            \n              Moore\n              R,\n            \n            \n              Linnane\n              J.\n            \n          \n          Rivaroxaban for treatment of pulmonary embolism while receiving electroconvulsive therapy.\n\t\t\t\t\tJ ECT.\n\t\t\t\t\t2017;\n\t\t\t\t\t33(3):\n\t\t\t\t\te25-\n\t\t\t\t\t6.\n\t\t\t\t\tDOI: 10.1097\/YCT.0000000000000396. PubMed PMID: 28198719.","DOI":"10.1097\/YCT.0000000000000396"},{"key":"2021071617405573800_i2168-9709-11-4-254-b16","doi-asserted-by":"crossref","unstructured":"Schmidt\n              ST,\n            \n            \n              Lapid\n              MI,\n            \n            \n              Sundsted\n              KK,\n            \n            \n              Cunningham\n              JL,\n            \n            \n              Ryan\n              DA,\n            \n            \n              Burton\n              MC.\n            \n          \n          Safety of electroconvulsive therapy in patients receiving dabigatran therapy.\n\t\t\t\t\tPsychosomatics.\n\t\t\t\t\t2014;\n\t\t\t\t\t55(4):\n\t\t\t\t\t400-\n\t\t\t\t\t3.\n\t\t\t\t\tDOI: 10.1016\/j.psym.2013.06.010. PubMed PMID: 23932534.","DOI":"10.1016\/j.psym.2013.06.010"},{"key":"2021071617405573800_i2168-9709-11-4-254-b17","doi-asserted-by":"crossref","unstructured":"Dlott\n              JS,\n            \n            \n              George\n              RA,\n            \n            \n              Huang\n              X,\n            \n            \n              Odeh\n              M,\n            \n            \n              Kaufman\n              HW,\n            \n            \n              Ansell\n              J,\n            \n            et al.\n          \n          National assessment of warfarin anticoagulation therapy for stroke prevention in atrial fibrillation.\n\t\t\t\t\tCirculation.\n\t\t\t\t\t2014;\n\t\t\t\t\t129(13):\n\t\t\t\t\t1407-\n\t\t\t\t\t14.\n\t\t\t\t\tDOI: 10.1161\/circulationha.113.002601. PubMed PMID: 24493817.","DOI":"10.1161\/CIRCULATIONAHA.113.002601"},{"key":"2021071617405573800_i2168-9709-11-4-254-b18","doi-asserted-by":"crossref","unstructured":"Saha\n              D,\n            \n            \n              Bisui\n              B,\n            \n            \n              Thakurta\n              RG,\n            \n            \n              Ghoshmaulik\n              S,\n            \n            \n              Singh\n              OP.\n            \n          \n          Chronic subdural hematoma following electro convulsive therapy.\n\t\t\t\t\tIndian J Psychol Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t34(2):\n\t\t\t\t\t181-\n\t\t\t\t\t3.\n\t\t\t\t\tDOI: 10.4103\/0253-7176.101799. PubMed PMID: 23162198.","DOI":"10.4103\/0253-7176.101799"},{"key":"2021071617405573800_i2168-9709-11-4-254-b19","doi-asserted-by":"crossref","unstructured":"Carlson\n              EWJ,\n            \n            \n              Weeks\n              H,\n            \n            \n              Couldwell\n              WT,\n            \n            \n              Kalani\n              MYS.\n            \n          \n          Intraparenchymal hemorrhage after electroconvulsive therapy.\n\t\t\t\t\tInterdiscip Neurosurg.\n\t\t\t\t\t2017;\n\t\t\t\t\t9:\n\t\t\t\t\t89-\n\t\t\t\t\t91.\n\t\t\t\t\tDOI: 10.1016\/j.inat.2017.07.012.","DOI":"10.1016\/j.inat.2017.07.012"},{"key":"2021071617405573800_i2168-9709-11-4-254-b20","doi-asserted-by":"crossref","unstructured":"Di\n              X,\n            \n            \n              Chen\n              M,\n            \n            \n              Shen\n              S,\n            \n            \n              Cui\n              X.\n            \n          \n          Antipsychotic use and risk of venous thromboembolism: a meta-analysis.\n\t\t\t\t\tPsychiatry Res. 2021;296:\n\t\t\t\t\t113691.\n\t\t\t\t\tDOI: 10.1016\/j.psychres.2020.113691. PubMed PMID: 33421839.","DOI":"10.1016\/j.psychres.2020.113691"}],"container-title":["Mental Health Clinician"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/11\/4\/254\/2868695\/i2168-9709-11-4-254.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/11\/4\/254\/2868695\/i2168-9709-11-4-254.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T16:23:51Z","timestamp":1731687831000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/11\/4\/article-p254.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,7,16]]},"published-print":{"date-parts":[[2021,7,1]]}},"URL":"https:\/\/doi.org\/10.9740\/mhc.2021.07.254","relation":{},"ISSN":["2168-9709"],"issn-type":[{"value":"2168-9709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,1]]}}}