Payne; Joan Prudic Author Information: InItalian scientists first applied electrically induced therapeutic seizures. Although electroconvulsive therapy ECT is employed in the treatment of several psychiatric disorders, it is most frequently used today to treat severe depressive episodes and remains the most effective treatment available for those disorders.
In a descriptive systematic review of papers and reports that included testimonies, approximately half the patients reported that they had received sufficient information about ECT and adverse effects. In that review, approximately one third of patients did not feel they had freely consented to ECT, even when they had signed a consent form.
No clear consensus about how to determine capacity to consent has been established. The capacity to consent has generally been interpreted as evidence that the patient can understand information about the procedure and can act responsibly on the basis of this information.
Involuntary ECT should be reserved for patients who need emergency treatment and who have a legally appointed guardian who has agreed to the use of ECT.
Antacid medications and proton pump inhibitors may be safely used. Diagnostic considerations for ECT in an adolescent patient [ 66 ] include severe or persistent major depression or mania [ 67 ] with or without psychotic features, schizoaffective disorder, schizophrenia, catatonia, [ 68 ] or neuroleptic malignant syndrome.
The symptoms must be severe, persistent, and significantly disabling, and they may include life-threatening symptoms.
Before considering ECT in children and adolescents, lack of treatment response should be documented. Lack of treatment response is defined as failure to respond to at least 2 adequate trials of appropriate psychopharmacological agents accompanied by other appropriate treatment modalities.
Patients in late pregnancy should lie on their left side during ECT to ensure adequate blood flow to the fetus. Hyperventilation is to be avoided.
Anesthetic agents pose little risk to the nursing infant. Exposure of nursing infants to medications may be decreased if the mother delays feeding for several hours after an ECT treatment. Alternatively, breast milk may be collected and stored before an ECT treatment and given via bottle after an ECT treatment.
A brief pulse waveform is used in modern electroconvulsive therapy ECT machines. Empirical titration Formula-based titration Fixed dosages In empirical titration, progressively higher doses are given during the first ECT session until seizure threshold is reached.
This provides the most precise method for determining seizure threshold. In the third method, a fixed dose is given independent of patient or other factors. A fourth method, called the glissando technique, in which the stimulus intensity is progressively increased during delivery from a subconvulsive to a convulsive level, has not been justified.
It is now of only historical interest. Nevertheless, if the seizure duration is less than 15 seconds in motor and EEG manifestations, the seizure was very likely limited by insufficient electrical stimulation. Although the typical number of treatments is[ 1244 ] some patients may respond after a few treatments, and some patients may not respond until after 10 treatments.This is a response to Dr Charlotte Rosalind Blease’s paper ‘Electroconvulsive Therapy (ECT), the Placebo Effect and Informed Consent’, written by Julie K.
Hersh who has had ECT.
Hersh argues that placebo effect is impossible to prove without endangering the lives of participants in the study. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally.
The use of electroconvulsive therapy (ECT) in the concept of beneficence and maleficence, we must be mindful that Sachs M & Madaan V. Electroconvulsive Therapy in Children and Adolescents: Brief Overview and Ethical Issues. 5. lawsuit claiming “torture” with ECT, and.
In , Ms. A, a teacher with a master's degree in education, was referred for electroconvulsive therapy (ECT) by her psychiatrist because she was experiencing a severe melancholic depression with profound agitation and had failed to respond to multiple medications.
Ms. Electroconvulsive therapy (ECT) induces a cerebral seizure by electrical stimulation under general anesthesia and muscle relaxation, is regarded as a highly efficient (for specific and severe psychiatric disorders) and extremely safe modern treatment option.
Electroconvulsive therapy (ECT) is a procedure used to treat severe depression. It may be used in people who have symptoms such as delusions, hallucinations, or suicidal thoughts or when other treatments such as psychotherapy and antidepressant medicines have not worked.