Major depressive disorder ECT
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mitra Chitsazan, M.D.[2]
Overview
Electroconvulsive therapy (ECT), also known as electroshock or electroshock treatment, uses short bursts of a controlled current of electricity (typically fixed at 0.9 amperes) into the brain to induce a brief, artificial seizure while the patient is under general anesthesia.
ECT
- Electroconvulsive therapy (ECT), also known as electroshock or electroshock treatment, uses a brief pulse (0.5 to 2.0 milliseconds) or ultra-brief pulse (less than 0.5 milliseconds) waveform of a controlled current of electricity (typically fixed at 0.9 amperes) into the brain to induce a brief, artificial seizure while the patient is under general anesthesia. [1] [2] [3] [4]
- In contrast to direct electroshock of years ago, most countries now allow ECT to be administered only under anesthesia.
- In a typical regimen of treatment, a patient receives three treatments per week over three or four weeks. Repeat sessions may be needed.
- Short-term memory loss, disorientation, and headache are common side effects. Detailed neuropsychological testing in clinical studies has not been able to prove permanent effects on memory.
- ECT offers the benefit of a very fast response; however, this response has been shown not to last unless maintenance electroshock or maintenance medication is used. Whereas antidepressants usually take around a month to take effect, the results of ECT have been shown to be much faster. For this reason, it is the treatment of choice in emergencies (e.g., in catatonic depression in which the patient has ceased oral intake of fluid or nutrients).
- ECT is most helpful in treating treatment-resistant major depressive disorder severe major depressive disorder impairing activities of daily living.
- Patients with suicidality, major depressive episodes with psychotic features, food refusal secondary to depression, and catatonia may also benefit from ECT.
References
- ↑ American Psychiatric Association. Task Force on Electroconvulsive Therapy (1990). "The Practice of ECT: Recommendations for Treatment, Training and Privileging". Convuls Ther. 6 (2): 85–120. PMID 11659302.
- ↑ Taylor S (2007). "Electroconvulsive therapy: a review of history, patient selection, technique, and medication management". South Med J. 100 (5): 494–8. doi:10.1097/SMJ.0b013e318038fce0. PMID 17534086.
- ↑ Gomez GE (2004). "Electroconvulsive therapy: present and future". Issues Ment Health Nurs. 25 (5): 473–86. doi:10.1080/01612840490443446. PMID 15204891.
- ↑ Oral ET, Tomruk N, Plesnicar BK, Hotujac L, Kocmur M, Koychev G; et al. (2008). "Electroconvulsive therapy in psychiatric practice: a selective review of the evidence". Neuro Endocrinol Lett. 29 Suppl 1: 11–32. PMID 19029876.