Loma Linda University

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Ronald Warnell, MD
Assoc Clin Prof, Psychiatry
School of Medicine
Publications    Book Review - Scholarly Journals--Published
  • Warnell RL, Swartz CM, Thomson A: Using 0.5mg Pulsewidth Prevents Basic ECT Side-Effects and Propofol Interruption Diminishes Subtle Side-Effects. J ECT 2009;25:150-151(Abstract) ( 5/2009 - 7/2010 )
  Scholarly Journals--Published
  • Ronald Warnell, M.D; Nazanin Elahi, M.D.. "Introduction of vagus nerve stimulation into a maintenance electroconvulsive therapy regimen: a case study and cost analysis." The Journal of ECT . (2007): 114-119. ( 6/2007 )
    Objective To describe the outcome of a patient implanted with the Vagus Nerve Stimulation (VNS) Therapy device while receiving maintenance electroconvulsive treatment (M-ECT) and to compare costs of treatment options for TRD. Background Vagus nerve stimulation was approved for use in treatment-resistant depression in July, 2005. Maintenance ECT was used for this patient before VNS implantation and for several treatments afterwards. The patient responded to ECT but the response was short-lived requiring frequent M-ECT accompanied by some memory disturbance. Design/Methods Single case report at tertiary care center; cost comparison over time. Main outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). Cost Analysis of Modalities- M-ECT $800 per treatment; VNS ~$3900 per year. Results ? Patient improved with VNS Therapy and was able to discontinue M-ECT. ? MADRS scores had fluctuated between 2 and 56, but, after VNS Therapy, decreased to a level consistent with remission of depression. ? Patient reported feeling as well as at any time he could remember, began an exercise program, and lost 30 pounds. During the10 months before implantation, 14 ECT treatments=$11,200 For 10 months after implantation, 7 M-ECT treatments ($5,600) plus prorated VNS Therapy ($3,250) equaled $8,850, $2,350 less than before implantation. Conclusion This patient improved with VNS Therapy and was able to discontinue M-ECT. Introducing VNS Therapy effected a cost savings over M-ECT
  • Ronald L. Warnell, M.D.;Anthony D. Duk, M.D;George W. Christison, M.D.; Mark G. Haviland, Ph.D.. "Teaching Electroconvulsive Therapy to Medical Students; Effects of Instructional Method on Knowledge and Attitude." Academic Psychiatry 29.5 (2005): 433-436. ( 11/2005 )
  • Ronald L. Warnell, M.D.. "Successful Use of Left-Unilateral Electroconvulsive Therapy in a Right-Handed Male." The Journal of ECT 20.2 (2004): 123-126. ( 6/2004 )
  Scholarly Journals--Accepted
  • Warnell RL, Swartz CM, Thomson A:Propofol interruption of ECT seizure to reduce side-effects: a pilot study. Psychiatry Research 2010;175:184-185. ( 8/2009 )