With the improvement of its technique, electroconvulsive therapy has become an even safer and more useful procedure both for the acute phase and for the prevention of new depressive episodes. Learn about electroconvulsive therapy ect for depression as an alternative treatment option for patients who are unresponsive to antidepressant medications. Very occasionally, ect is prescribed for people experiencing mania. Electroconvulsive therapy procedure electroconvulsive therapy ect is a procedure that entails induction of a seizure by applying an electrical stimulus to the brain. A significantly greater percent of patients receiving ect had. Electroconvulsive therapy ect is used in patients with. Electroconvulsive therapy today in depth report people who have had ect before and responded well are good candidates for ect. See subheading the integrative methodological approach.
I f major depression were not a serious public health problem in the elderly population, there would be no need to discuss electroconvulsive therapy ect in this book. Major depression can be a serious and debilitating condition. Electroconvulsive therapy ect is a safe and effective treatment for a variety of psychiatric and some medical conditions. Pdf major depression can be a serious and debilitating condition. The coach quips, you know, im no doctor, jarrett, but i would. Electroconvulsive therapy, or ect, is often used effectively for depression that is hard to treat. Chapter electroconvulsive therapy in latelife depression 391 sackeim et al.
Ect is safe, painless and very effective in treating depression. Electroconvulsive therapy ect is one of the most studied and most effective treatments for selected severe mental illness such as major depression with psychotic feature. Electroconvulsive therapy ect is one of the most effective treatments for severe major depressive disorder mdd, carrying benefits of relatively high response and initial remission rates 1 in an efficient time frame e. A psychiatrist might suggest electroconvulsive therapy ect or other forms of brain stimulation. An 82yearold woman with severe depression, including psychotic symptoms, is referred for consideration of electroconvulsive therapy. Ect, or electroconvulsive therapy, is an alternative therapy for certain psychiatric illnesses that are not responding to traditional treatments. Compared to pharmacologic treatments, ect is administered to an especially high proportion of elderly patients.
In fact, it is safe and effective for treating severe depression when patients have symptoms that havent responded to medication, counselling or other psychosocial treatments. Pdf electroconvulsive therapy and its use in modernday psychiatry. Electroconvulsive therapy canadian psychiatric association. Ect is therapeutic induction of generalized seizure activity with brief electric pulses via electrodes placed on patients head 1,3,4,5. The improvement was greatest in elderly patients, who more often had psychotic features. The overarching aims of the thesis were to identify clinical characteristics thatpredict the outcomes depressed patients treated in of clinical practice by ect, and. Over 7500 australians and 300 new zealanders have ect treatment each year. Brain changes induced by electroconvulsive therapy are broadly. These groups inaccurately perceive ect as invasive and brain damaging and insist that no reasonable person can give an informed. Research studies have shown that ect is the most effective and rapid treatment available for elderly patients with depression, bipolar disorder and psychosis. This effect could not be explained by other contributing factors and is especially remarkable because patients aged 70 years or older were. Yet, major depression is one of the most common and serious illnesses in the elderly see chapter. A, a 72yearold recently retired professional, presents for outpatient psychiatric treatment of an ongoing episode of major depression with psychotic features. Electroconvulsive therapy and its different indications.
Privileging for ect practice at institutions is a local option. For some people, medications are an effective treatment. Critics of ect say its a crude tool of psychiatric coercion. Ect has also been shown to be effective for bipolar mood disorders depression, mania or mixed states, schizoaffective disorder, schizophrenia. Ect, tms and other brain stimulation therapies nami. Ect is most commonly used to treat severe depression major depression. Genuine ect is substantially more effective in the acute treatment of depression than sham ect. Electroconvulsive therapy today indepth report people who have had ect before and responded well are good candidates for ect. Electroconvulsive therapy ect electroconvulsive therapy ect is one of the most controversial and misunderstood treatments for mental illness. Brain stimulation techniques such as electroconvulsive therapy ect, for example, can be used to. Kaiser foundation health plan of washington and kaiser foundation health plan of washington options, inc. Electroconvulsive therapy, or ect for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain also known as a. Download our consent for electroconvulsive therapy ect form pdf.
Webmd explains how it works and its side effects and risks. It is typically administered by a team of trained medical professionals. To date, electroconvulsive therapy ect is the most potent treatment in severe depression. Pdf electroconvulsive therapy in latelife depression. Costeffectiveness of electroconvulsive therapy compared. Other firstline indications for the procedure include people who are catatonic or suffering from a form of depression known as psychotic depression depression associated with delusions and hallucinations.
Electroconvulsive therapy, or ect for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain also known as a seizure. Ect is demonstrated to be a potent treatment for depression. Electroconvulsive therapy this report was funded by the ministry of health services and carried out under contract with the mental health evaluation and community consultation unit mheccu. Ect is especially helpful for severe or treatmentresistant illness. Pdf pelectroconvulsive therapy ect has been regarded as a some what controversial treatment modality. Electroconvulsive therapy and its different indications ncbi.
Electroconvulsive therapy ect is an extremely safe and effective medical treatment for certain psychiatric disorders. Pdf depression, memory and electroconvulsive therapy. The efficacy of ect to treat depressive symptoms has been established by means of innumerable studies developed during the last decades. Efficacy and safety of electroconvulsive therapy in depressive. Results from previous studies comparing the costeffectiveness of this technique with treatment alternatives such as repetitive transcranial magnetic stimulation rtms are conflicting. Electroconvulsive therapy ect is widely applied to treat severe depression resistant to standard treatment.
Brief overview and ethical issues 2 the use of electroconvulsive therapy ect in the electroconvulsive therapy ect is the most effective acute treatment for severe depression, but widely held concerns about memory problems may limit its use. Beneficial effects of electroconvulsive therapy in elderly. Ect is often prescribed as a treatment for depression when other treatments. Electroconvulsive therapy remains a highly efficacious treatment in treatmentresistant depression. Importance electroconvulsive therapy ect is a highly effective treatment for depression but is infrequently used owing to stigma, uncertainty about indications, adverse effects, and perceived high cost. It is often the fastest and best treatment available for this illness. Electroconvulsive therapy ect is a medical treatment for severe depression, mania and schizophrenia. Patients can be given medications prior to ect if headache or nausea is a problem.
Background electroconvulsive therapy ect is the most effective acute treatment for severe depression, but widely held concerns about memory problems may limit its use. Read about the history of ect and costs and side effects of the procedure. Electroconvulsive therapy depression is different from. Electroconvulsive therapy ect is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments. Ect has received much attention in the mainstream media. Sackeim electroconvulsive therapy ect plays a significant role in the treatment of latelife depression and other psychiatric conditions in the elderly. Before commencing a course of ect, patients will undergo a thorough psychiatric.
Electroconvulsive therapy is not a required subject in us medical schools and not a required skill in psychiatric residency training. Electroconvulsive therapy ect patient information booklet page 1 of 8 what is ect. Electroconvulsive therapy ect can provide rapid, significant improvements in severe symptoms of several mental health conditions. Electroconvulsive therapy is one of the most controversial treatments in medicine. Mcclintock, ect has a 7583% success rate in battling depression however.
In their article1 published in the lancet psychiatry, roxanne schaakxs and colleagues describe an agedependent, linearly worse outcome of major depressive disorder mdd in terms of both symptom persistence and longer time to remission in elderly people. Severe depression, particularly when accompanied by detachment from reality psychosis, a desire to commit suicide or refusal to eat. Electroconvulsive therapy in children and adolescents. A 72yearold woman with treatmentresistant major depression is considered for ect. Question what is the costeffectiveness of electroconvulsive therapy compared with antidepressant medications andor psychotherapy for treatmentresistant major depressive disorder in the united states findings in this mathematical modeling analysis integrating data from multiple published sources, offering electroconvulsive therapy as thirdline treatment for depression would. For some patients in a treatment resistant depressive episode, electroconvulsive. A populationbased study with a matched control group. When medication fails to ease the symptoms of clinical depression, there are other options to try. It is also used to treat other forms of mental illness. Clinical experience and evidencebased research have provided support for the efficacy of electroconvulsive therapy ect for unipolar depressive episodes, but the relative efficacy of ect in treatmentresistant bipolar depression remains understudied.
Electroconvulsive therapy ect remains the most efficient therapy for severe and treatment resistant depression, with rates and time. Ect is also sometimes used to treat other psychiatric disorders, such as. Previous position papers were published in 1980 1 and 1992. Psychiatric disorders treated with ect major depression severe with or without psychotic features bipolar disorder currently depressed or rarely manic schizophrenia with mood component. Pdf electroconvulsive therapy for depression michael. Mood incongruent delusions predicted good treatment response. The royal college of psychiatrists statement on electroconvulsive therapy advises that cognitive functioning should be assessed before ect and monitored after every three or four ects, and also after the final ect. Ect was introduced in 1938 and has since undergone dramatic changes so that modern ect no longer resembles the early treatment often portrayed in the media. Electroconvulsive therapy ect is a safe and effective treatment for certain psychiatric disorders. Ect is the best studied brain stimulation therapy and has the longest history of use. Apr 04, 2020 electroconvulsive therapy ect is an effective treatment for clinical depression or major depression, as well as in some forms of recurrent or chronic clinical depression with one big caveat. Ect is a procedure in which a small amount of electricity is applied to the scalp to produce a brief seizure in the brain. Provincial clinical knowledge topic electroconvulsive.
Use of electroconvulsive therapy in bipolar depression. Bipolar depression, which dominates the longitudinal course of bipolar disorder, is associated with psychosocial and cognitive impairment and. Efficacy and safety of electroconvulsive therapy in depressive disorders. Electroconvulsive therapy in latelife depression harold a. Mar 22, 2020 ect, or electroconvulsive therapy, is an alternative therapy for certain psychiatric illnesses that are not responding to traditional treatments. The introduction of electroconvulsive therapy ect for the treatment of serious mental disturbs, such as major depression and bipolar disorder, was one of most impacting revolutions of psychiatry.
Electroconvulsive therapy ect is handsdown the most contr oversial treatment in modern psychiatry. Electroconvulsive therapy ect johns hopkins medicine. When treatments such as medication and therapy arent able to relieve the symptoms of depression or another mental health condition, there are other options available. She has had four episodes of major depression consisting of cr. Real ect was significantly more effective than simulated ect six trials, 256 patients, standardised effect size ses 091, 95% ci 127 to 054. Some people may be given some of their cardiac medications prior to ect with sips of water.
No other treatment has generated such a fierce and polarized public debate. Rehospitalization of postpartum depression and psychosis after electroconvulsive therapy. Current electroconvulsive therapy practice and research in the. How electroconvulsive therapy works understanding the. In some cases of severe depression ect is prescribed because the standard treatments have not worked. Patients will be asked to dress in a gown for treatment they may wear their underwear or pajama bottoms. For some patients in a treatment resistant depressive episode. Provincial clinical knowledge topic electroconvulsive therapy.
The aim of the treatment is to relieve the symptoms of some mental health problems. She reports a history of mild postpartum depression 40 years. Electroconvulsive therapy ect is the most effective treatment for mdd and the goldstandard therapy for treatmentresistant depression trd, yet it remains underutilized due to factors such as limited availability, stigma, and concerns about cognitive side effects. It has proven superiority in prospective studies comparing ect with sham ect1,2, and with standard antidepressant. Electroconvulsive therapy reduces frontal cortical. Electroconvulsive therapy ect electroconvulsive therapy ect is the most effective treatment for depression. Ect is most commonly used to treat severe or treatmentresistant depression. Ect involves a small electrical current being carefully passed through the brain. Electroconvulsive therapy ect is a treatment for people with severe or recurrent depression.
It is an effective and well established treatment method for depression and other mental disorders. Depressive stupor and inanition, as in melancholic, catatonic, or psychotic depression, can be a firstline indication for ect before other. Electroconvulsive therapy ect electroconvulsive therapy. The use of electroconvulsive therapy ect in the depression. Electroconvulsive therapy ect and other brain stimulation therapies may be an option for people with severe depression who do not respond to antidepressant medications. Electroconvulsive therapy ect is a physical treatment used for a range of mental illnesses. Electroconvulsive therapy treating depression with expertise and compassion. Electroconvulsive therapy, adult inpatient, ambulatory v 1. Electroconvulsive therapy ect department of psychiatry. Very occasionally, ect is prescribed for people experiencing. Major depressive disorder mdd is the most common mental illness and the leading cause of disability worldwide.