ect and its benefits

8/6/2019 Ect and Its Benefits

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INTRODUCTIONy Formerly known as electroshock.

y ECT is most often recommended for use as a treatment

for severe depressions which has not responded toother treatment.

y It was first introduced in 1938 and gained widespreaduse as a form of treatment in the 1940s and 1950s


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Early Theoriesy Hippocrates: Documented the cure of insane patient

following malaria-induced seizures.

y Swiss physician Paracelsus in 1500s, induced seizureswith oral camphor to treat mania and psychosis.


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Electrically induced Seizuresy In 1937, Italian physicians Cerletti & Bini applied

electricity to head to induce therapeutic seizures.

y

First patient had catatonia and he improved.y Safer than chemically induced seizures.

yWidespread acceptance through out Europe and USA.


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y Electroconvulsive therapy can differ in its applicationin three ways:

electrode placement

frequency of treatments

the electrical waveform of the stimulus


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yAfter treatment, drug therapy is usually continued,and some patients receive continuation/maintenance

ECT.


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The Benefits of ECTy Half those who remit then relapse within six months

y discontinuing antidepressant medication


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Probability ofremissiony 1999

y both clinical experience and published studies had

determined ECT to be effectivey 60%-70%

y depression, some acute psychotic states, and mania


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y 2004

y New Yorkdescribing itself as the first systematic

documentation of the effectiveness of ECT incommunity practice in the 65 years of its use

y found remission rates of only 30%-47%, with 64% ofthose relapsing within six months.


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y However, when patients with co-morbid personalitydisorders or who were suffering from schizoaffective

disorder were removed from the analysis, theremission rates climbed to 60%-70%.


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Degree of effectivenessy ECT is effective in the treatment of depression.

y 2003

y The UK ECT Review group published a systematicreview and meta-analysis comparing ECT to placeboand antidepressant drugs.


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y 2006, research psychiatrist Colin A. Ross reviewed theplacebo-controlled trials one-by-one and found that

no single study showed a significant differencebetween real and placebo ECT at one month post-treatment.


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y 2010 (Bentall and Read)

y Their conclusions are as follows: Given the strong

evidence of persistent and, for some, permanent braindysfunction, primarily evidenced in the form ofretrograde and anterograde amnesia, and the evidenceof a slight but significant increased risk of death, the

cost-benefit analysis for ECT is so poor that its usecannot be scientifically justified.


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Related experimental therapeuticsy Recent research has investigated whether implantable

devices such as DBS (deep brain stimulation) could

result in clinical improvements for patients withtreatment-resistant depression. However, in NorthAmerica, DBS has not been authorized as an approved,effective therapy for treatment-resistant depression.


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CONCLUSION

The effects of using ECT can often

be gained almost immediately.

M

any patients have reportedfeeling less depressed after theirvery first series of shocks

ect and its benefits

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