ECT is thought to reverse depression by enhancing the release of excitatory neurotransmitters. In individuals who have acute suicidal ideations or acute depression, ECT can belief saving and is often considered the primary therapy. Other individuals who may benefit from ECT are those who have failed drug therapy or those with acute psychotic episodes.
The controversy surrounding ECT stems from the fact that results about the procedure are often reported by non health care professionals. Like any other mental health treatment, ECT is also not 100% effective in all individuals. Granted in the old days the technique of administering the electric shock was crude and anesthesia was still in infancy. Things have changed a lot over the past 4 decades. ECT is a lot safer today and considerably safer than many of the drugs used to treat mental health disorder.
Whether to undergo ECT is a difficult choice for many consumers. The questions that are often asked is whether it will work, when it should be administered, does it have long lasting side effects or will the individual be normal are genuine concerns for all patients.
The only way to make a valid decision about this therapy is to be well informed.
Saturday, February 14, 2009
Much Ado About Electro convulsive therapy
Most people seem to think that Electroconvulsive therapy (ECT) is a dangerous treatment often given to prisoners or to punish a patient. Others seem to think that the treatment is painful and causes life long complications. The misconceptions have arisen primarily because health care professionals simply have not made an effort to educate the public
Electroconvulsive Therapy is generally performed by a psychiatrist. ECT is bona fide therapy with great benefits for certain depressed patients and is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health, the Food and Drug Administration and the US Surgeon General's office.
Most individuals only receive 6-12 ECT sessions spread over an interval of a few months. The treatments are given 2-3 times a week for a month as an outpatient. The treatments are administered under general anesthesia and the patient is also given a muscle relaxant. The brain is connected with electrodes that are placed in specific locations over the scalp. Once the individual is asleep, an electrical current that causes a seizure is delivered. The seizure typically lasts about 45-60 seconds. There is no pain or any other visible symptom after the procedure.
Electroconvulsive Therapy is generally performed by a psychiatrist. ECT is bona fide therapy with great benefits for certain depressed patients and is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health, the Food and Drug Administration and the US Surgeon General's office.
Most individuals only receive 6-12 ECT sessions spread over an interval of a few months. The treatments are given 2-3 times a week for a month as an outpatient. The treatments are administered under general anesthesia and the patient is also given a muscle relaxant. The brain is connected with electrodes that are placed in specific locations over the scalp. Once the individual is asleep, an electrical current that causes a seizure is delivered. The seizure typically lasts about 45-60 seconds. There is no pain or any other visible symptom after the procedure.
Current Recommendations on Electroconvulsive therapy Usage Part 2
ECT is used much less often today partly because of the availability of more potent and safer anti depressants and also the development of the field of psychotherapy. Plus, there are a variety of organizations and social support groups to help mental health patents overcome their disabilities
Even so, depression can take an acute turn for the worse with the individual going downhill fast and not eating, talking or even communicating. Some may develop acute psychosis and delusions and become very suicidal.
In these cases, ECT may offer a rapid therapeutic benefit compared to what is available and may be an excellent alternative. All current scientific data indicate that for acute depression with suicidal tendencies, ECT is an excellent form of therapy.
Many individuals who have had ECT in the past have found it helpful and seek the treatment when they feel depressed again.
ECT is relatively expensive. The costs of the treatment depend on which state one is receiving the therapy, the cost of anesthesia and the fees of the psychiatrist. On average the costs of ECT are about $ 800-$1200. The cost covers the fee for anesthesia, the psychiatrist and hospital admission. Most individuals receive anywhere from 6-8 treatments.
Many medical insurance plans and Medicare do reimburse the cost of ECT. While this may not sound cheap, it is a lot cheaper than taking anti depressant drugs for life
Even so, depression can take an acute turn for the worse with the individual going downhill fast and not eating, talking or even communicating. Some may develop acute psychosis and delusions and become very suicidal.
In these cases, ECT may offer a rapid therapeutic benefit compared to what is available and may be an excellent alternative. All current scientific data indicate that for acute depression with suicidal tendencies, ECT is an excellent form of therapy.
Many individuals who have had ECT in the past have found it helpful and seek the treatment when they feel depressed again.
ECT is relatively expensive. The costs of the treatment depend on which state one is receiving the therapy, the cost of anesthesia and the fees of the psychiatrist. On average the costs of ECT are about $ 800-$1200. The cost covers the fee for anesthesia, the psychiatrist and hospital admission. Most individuals receive anywhere from 6-8 treatments.
Many medical insurance plans and Medicare do reimburse the cost of ECT. While this may not sound cheap, it is a lot cheaper than taking anti depressant drugs for life
Current Recommendations on Electroconvulsive therapy Usage
Electroconvulsive therapy (ECT) used to be a dangerous treatment 50 years ago but a lot has changed today. Over the past 30 years, the techniques of anesthesia have greatly improved, we have better and safer sedative drugs, there are monitoring machines and the procedure is always done in a health care facility.
Unlike the past, ECT today is a bona fide treatment for some mental health disorders and not a sadistic procedure as depicted in the movies. It is very rare for any individual to complain of pain before, during or after the procedure. Medicine was primitive 50 years ago and no doubt was a cause of many painful ordeals-but this was not unique to ECT but to all of medicine and surgery.
Today, the American Psychiatric Association has very strict guidelines for ECT administration. One can not simply hand over a prescription to a patient to go to a hospital and have shock therapy. The American psychiatric organization supports use of ECT only to treat severe, disabling mental disorders and is never used to control behavior.
Despite its dubious past, electroconvulsive therapy is now a relatively safe and effective procedure. Compared to the conventional anti depressants, ECT works faster and can help resolve acute depression when other treatments have failed. However, like all things in medicine, ECT does have certain risks which are real but very small.
Unlike the past, ECT today is a bona fide treatment for some mental health disorders and not a sadistic procedure as depicted in the movies. It is very rare for any individual to complain of pain before, during or after the procedure. Medicine was primitive 50 years ago and no doubt was a cause of many painful ordeals-but this was not unique to ECT but to all of medicine and surgery.
Today, the American Psychiatric Association has very strict guidelines for ECT administration. One can not simply hand over a prescription to a patient to go to a hospital and have shock therapy. The American psychiatric organization supports use of ECT only to treat severe, disabling mental disorders and is never used to control behavior.
Despite its dubious past, electroconvulsive therapy is now a relatively safe and effective procedure. Compared to the conventional anti depressants, ECT works faster and can help resolve acute depression when other treatments have failed. However, like all things in medicine, ECT does have certain risks which are real but very small.
What is status of Electroconvulsive therapy today? Part 2
ECT in the present era of medicine is safe and bona fide therapy. The reason for the bad reputation is because delivery of ECT in the older days was never controlled and complications were never anticipated. Today, a lot more is known about the therapy and both delivery and safety have been refined and improved to near perfection.
Who is a candidate for ECT?
ECT is generally reserved for individuals who have:
- severe depression, accompanied by acute psychosis or suicidal ideations
- failed to respond to a variety of standard anti depressant drugs
- side effects or are unable to tolerate anti depressant drugs
- mild to moderate degree of psychosis which does not warrant the use of life long
drug therapy
- depression but have failed to respond to all forms of other therapies
Electroconvulsive therapy is a very effective and rapidly acting treatment for severe major depression. ECT has been found to be beneficial in individuals who suffer with some forms of mania (a mood episode which is associated with grandiose, hyperactive, irrational, and destructive behavior). When it comes to treatment of other mental health disorders like schizoaffective disorder, catatonia or Parkinson's disease, the role of ECT therapy is questionable.
ECT even though an effective treatment has been under utilized in the USA even though there are close to 9 million America who suffer from depression. Data indicate that only about 330,000 individuals have received ECT. ECT is delivered as an outpatient treatment.
Who is a candidate for ECT?
ECT is generally reserved for individuals who have:
- severe depression, accompanied by acute psychosis or suicidal ideations
- failed to respond to a variety of standard anti depressant drugs
- side effects or are unable to tolerate anti depressant drugs
- mild to moderate degree of psychosis which does not warrant the use of life long
drug therapy
- depression but have failed to respond to all forms of other therapies
Electroconvulsive therapy is a very effective and rapidly acting treatment for severe major depression. ECT has been found to be beneficial in individuals who suffer with some forms of mania (a mood episode which is associated with grandiose, hyperactive, irrational, and destructive behavior). When it comes to treatment of other mental health disorders like schizoaffective disorder, catatonia or Parkinson's disease, the role of ECT therapy is questionable.
ECT even though an effective treatment has been under utilized in the USA even though there are close to 9 million America who suffer from depression. Data indicate that only about 330,000 individuals have received ECT. ECT is delivered as an outpatient treatment.
What is status of Electroconvulsive therapy today? Part 1
After nearly 30 years of extensive use, there is no doubt that electroconvulsive therapy (ECT) is beneficial in the treatment of some patients with depression. However, the use of ECT in schizophrenia, mania or other mental health disorders is in limbo.
The majority of studies of ECT on mania and schizophrenia are difficult to interpret and the results remain inconclusive. Today, ECT is not a part of the therapeutic regimen of these disorders, except for a few isolated cases.
A lot of evidence exists which shows that ECT is a good form of therapy for individuals with depression. In many instances it has even been shown to be more effective than the conventional drug therapy using anti depressants. Over the years, psychiatrists have learnt that entire brain stimulation produces significantly much better results than stimulating only one half of the brain. Further, like all things American, more is better- meaning that a higher current produces better and long lasting results than use of low current.
In the past, individuals who received ECT were never thoroughly investigated or followed up. Misconceptions of the treatment arose because of anecdotal reports by patients and non health care professionals. The background of the patient, his/her co morbidity, personality, use of medications and other medical problems were never taken into account and everything negative was blamed on ECT.
Further during the evolution of the treatment many of the psychiatrists also failed to maintain safeguards to protect the patient. Infact for the major part of the history of ECT it was felt that the treatment created monsters. Today a lot has changed.
The majority of studies of ECT on mania and schizophrenia are difficult to interpret and the results remain inconclusive. Today, ECT is not a part of the therapeutic regimen of these disorders, except for a few isolated cases.
A lot of evidence exists which shows that ECT is a good form of therapy for individuals with depression. In many instances it has even been shown to be more effective than the conventional drug therapy using anti depressants. Over the years, psychiatrists have learnt that entire brain stimulation produces significantly much better results than stimulating only one half of the brain. Further, like all things American, more is better- meaning that a higher current produces better and long lasting results than use of low current.
In the past, individuals who received ECT were never thoroughly investigated or followed up. Misconceptions of the treatment arose because of anecdotal reports by patients and non health care professionals. The background of the patient, his/her co morbidity, personality, use of medications and other medical problems were never taken into account and everything negative was blamed on ECT.
Further during the evolution of the treatment many of the psychiatrists also failed to maintain safeguards to protect the patient. Infact for the major part of the history of ECT it was felt that the treatment created monsters. Today a lot has changed.
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