electroconvulsive therapy


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electroconvulsive therapy

in psychiatry, treatment of mood disorders by means of electricity; the broader term "shock therapy" also includes the use of chemical agents. The therapeutic possibilities of these treatments were discovered in the 1930s by Manfred Sakel, a Polish psychiatrist, using insulin; L. J. Meduna, an American psychiatrist, using Metrazol; and Ugo Cerletti and Lucio Bini, Italian psychiatrists, using electric shock. Metrazol and insulin accounted for a very limited number of remissions in cases of schizophrenia. However, the injection of insulin often caused coma, while Metrazol and electric shock resulted in convulsions similar to those of epileptics.

Advances in electroconvulsive therapy (ECT) have made it the standard mechanism of shock therapy. ECT has had unquestionable success with involutional melancholia and other depressive disorders, although it may be ineffective or only temporarily effective. ECT is generally employed only after other therapies for depression, mania, bipolar disorder or schizophrenia have proven ineffective. The administration of anesthetics and muscle relaxants prior to ECT has greatly reduced the risk of injury during the procedure, which is typically administered six to eight times over a period of several weeks. The seizure lasts for up to 20 seconds, and the patient can be up and about in about an hour. Long-term memory loss is the main significant potential side effect; headache, muscle stiffness, and temporary short-term memory loss may occur. Why ECT works, however, is still not understood, but it may be due to changes in brain chemistry caused by procedure, such as neurotransmittersneurotransmitter,
chemical that transmits information across the junction (synapse) that separates one nerve cell (neuron) from another nerve cell or a muscle. Neurotransmitters are stored in the nerve cell's bulbous end (axon).
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 released in the brain, or to a reduction in brain activity in certain areas after the procedure.

Bibliography

See A. S. Hermreck and A. P. Thal, The Adrenergic Drugs and Their Use in Shock Therapy (1968); L. B. Kalinowsky and H. Hippius, Pharmacological, Convulsive, and other Somatic Treatments in Psychiatry (1969).

electroconvulsive therapy

[i¦lek·trō·kən¦vəl·səv ′ther·ə·pē]
(psychology)
The technique of eliciting convulsions by applying an electric current through the brain of a human or an experimental animal for a brief period by means of electrodes that are placed on the head; sometimes used as a treatment for severe mental depression.
References in periodicals archive ?
Predictors of remission after electroconvulsive therapy in unipolar major depression.
Update for nurse anaesthetist-anaesthetic management during electroconvulsive therapy effect on seizure duration and antidepressant efficacy AANA J 1999; 67(1): 87-92.
Continuation and maintenance electroconvulsive therapy for mood disorders: review of the literature.
Comparison of propofol and thiopentone as anaesthesia agents for electroconvulsive therapy.
No causal association between electroconvulsive therapy and death: a summary of a report from the Danish Health and Medicines Authority covering 99,728 treatments.
Future research should address the dearth of appropriate, sensitive and brief measures tailored for the assessment of cognitive change during electroconvulsive therapy.
The presented case is of severe drug resistant neuroleptic malignant syndrome where patient remained in intensive care unit with ventilator support for a long time and finally responded to electroconvulsive therapy.
22) Evidence shows that the efficacy of right-unilateral electroconvulsive therapy depends on the electricaldose.
Psychiatrists and specialists working in biomedical and neuromotor sciences in Europe and the US describe definitions, staging models, and predictors of treatment-resistant depression; a new approach that includes classification as malignant, pernicious, or virulent; genetics; switching antidepressants; the role of atypical antipsychotics; lithium, thyroid hormones, and further augmentation strategies; nonpharmacological interventions like electroconvulsive therapy, repetitive transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation, and magnetic seizure therapy; and psychotherapy.
This edition of The ECT Handbook is the fourth report of the Special Committee on Electroconvulsive Therapy (ECT) and Related Treatments.
General anesthesia for electroconvulsive therapy with Brugada electrocardiograph pattern.