Electroconvulsive Therapy

ELECTROCONVULSIVE THERAPY (ECT)

Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, intentionally triggering a brief seizure.

Formerly known as electroshock Cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses It often works when other treatments are unsuccessful. Much safer today and is given to people while they're under general anesthesia. Usually used as a last line of intervention for major depressive disorder, schizophrenia, mania and catatonia. Involves multiple administrations, typically given two or three times per week until the patient is no longer suffering symptoms

It was first introduced in 1938 by Italian neuropsychiatrists Ugo Cerletti and Lucio Bini, and gained widespread popularity among psychiatrists as a form of treatment in the 1940s and 1950s. The World Health Organization (2005) advises that it should be used only with the informed consent of the patient or their proxy, only with adequate analgesia and muscle relaxants, and never on children.

Clients usually are given a series of 6 to 15 treatments scheduled 3 times a week. Generally a minimum of 6 treatments is needed to see sustained improvement in depressive symptoms. Maximum benefit is achieved in 12 to 15 treatments. Preparation of a client for ECT is similar to preparation for any outpatient minor surgical procedure. The client is NPO after midnight, removes any fingernail polish, and voids just prior to the procedure. An IV is started for the administration of medication.

Initially the client receives a short-acting anesthetic so he or she is not awake during the procedure. Next he or she receives a muscle relaxant, usually succinylcholine, that relaxes all muscles to reduce greatly the outward signs of the seizure (e.g., clonic, tonic muscle contractions). Electrodes are placed on the client’s head: one on either side (bilateral), or both on one side of the head (unilateral). Monitored by an electroencephalogram (EEG). Client receives oxygen and is assisted to breathe with an ambu bag. Vital signs are monitored, and the client is assessed for the return of a gag reflex.

Following ECT treatment: The client may be mildly confused or disoriented briefly. Is very tired and often has a headache. Headaches are treated symptomatically. The symptoms are just like those of anyone who has had a grand mal seizure. The client will have some short term memory impairment.

Unilateral ECT results in less memory loss for the client, but more treatments may be needed to see sustained improvement. Bilateral ECT results in more rapid improvement but with increased short term memory loss. Studies regarding the efficacy of ECT are as divided as the opinions about its use. Some studies report that ECT is as effective as medication for depression, while other studies report only short-term improvement. Likewise, some studies report that side effects of ECT are short-lived, while others report they are serious and long-term (Challiner, & Griffiths, 2000).

(^_^) the end!!!