In the United States, ECT is usually given three times a week; in the United Kingdom, it is usually given twice a week. Occasionally it is given on a daily basis. [1] A course usually consists of 6–12 treatments, but may be more or fewer.
Jul 29, 2011 · C-ECT was given at a predetermined fixed schedule with 4 weekly treatments the first month, followed by 4 biweekly treatments for 2 months and 2 monthly treatments for a total of 10 ECT in 6 months. Patients in this arm received no psychotropic medications except for lorazepam or diphenhydramine on an as-needed basis.
Jun 21, 2003 · Study selection Articles with patients' views after treatment with electroconvulsive therapy. Data extraction 26 studies carried out by clinicians and nine reports of work undertaken by patients or with the collaboration of patients were identified; 16 studies investigated the perceived benefit of electroconvulsive therapy and seven met ...
This compares with 305 or 7.5 people per 100,000 from 1 July 2003 to 30 June 2004. The average number of treatments per acute course of ECT was 7 treatments. Figure 1a and 1b illustrate the population-adjusted figures for the number of patients who received ECT per 100,000 population during the both reporting periods.
It is important to realize that a 'course ' of ECT entails a series of treatments given 2-3 times per week until maximal improvement has occurred. Most patients require 6 to 12 total treatments. People may still be depressed after 12 treatments and may require more. Every person is an individual and the total number of treatments may be more.
What comes to mind when you think about Electroconvulsive Therapy [ECT]? For many, visions of the old-fashioned shock therapies that required patients to wear a helmet covered in electrodes and endure large amounts of voltage come to mind. It’s often thought of as something from the Stone Age of medicine and is barbaric at best. What you might not know is that ECT is not only still in use today, but it is often prescribed more often than you might think.
People are more likely to receive ECT between the ages of 50-69 more than any other age group. This accounts for nearly half of all treatments. 6. ECT is rarely a first-time treatment option in youth – only 35 kids between 16-19 years of age received a treatment in the last year. 7.
1. Some studies have found that the fatality rate in ECT treatments is as high as 2.9 per 10,000 patients. Others have found fatality rates to be as low as 4.5 per 100,000 patients.#N#2. Up to 40% of ECT patients in New York receive treatments based on court orders. In Manhattan, up to 70% of the treatments that are given are court ordered.#N#3. According to statistics from California, 1 in 50 people who receive an ECT treatment have some form of memory loss afterward.#N#4. The amount of people who have memory loss according to APA data: 1 in 200.#N#5. People are more likely to receive ECT between the ages of 50-69 more than any other age group. This accounts for nearly half of all treatments.#N#6. ECT is rarely a first-time treatment option in youth – only 35 kids between 16-19 years of age received a treatment in the last year.#N#7. Over 100k treatments are given every year and that only includes information from hospitals that track this data.#N#8. Most ECT recommendations come from a minority of consultants. In one region in the UK, 15% of the consultants were responsible for 40% of the ECT treatments that were given.#N#9. When other medications are not used to treat mental health conditions, the success rate of an ECT treatment may be as high as 90%.#N#10. The relapse rate for ECT patients after 6 months: 70%.#N#11. A national survey of ECT survivors in 1995 found that 13.6% described their experience as “very helpful”, 16.5% “helpful”, 13.6% said it had made “no difference.”#N#12. For women who had an ECT treatment that they did not consent to having, half of them described the event as damaging. Only 8.6% said that the experience was very helpful.#N#13. The number of people diagnosed with manic depression after an ECT treatment: 1 in 2.#N#14. More than 35% of people who receive an ECT treatment are later diagnosed with schizophrenia.#N#15. According to the Royal College of Psychiatrists, over 80% of depressed patients who receive ECT respond well to it.#N#16. In the UK, nearly 20% of people who were offered ECT and refused it were not given any alternative form of treatment, even though their symptoms qualified as a diagnosable mental illness.#N#17. According to one survey of ECT patients, 55% of them felt that they had not regained their normal memory function three years after receiving their treatment.#N#18. Memory loss of any kind is responsible for up to 93% of all reported complications of ECT.#N#19. Nearly 18% of those receiving ECT during a 3 month period in 1999 did so without providing consent in the UK.
ECT works by delivering a shock to the mind that creates a seizure. In many ways, it seems to reboot the entire brain so that it can lift the veil of depression. It might even be able to reconnect nerves or neuroconnections that have stopped functioning properly for some reason.
Memory complications can easily last for up to 3 years past the procedure date.
Memory complications can easily last for up to 3 years past the procedure date. There are also other issues, such as poor circulatory health, that could actually end up causing someone to die during the procedure that is being forced upon them by the court system.
The number of people diagnosed with manic depression after an ECT treatment: 1 in 2. 14. More than 35% of people who receive an ECT treatment are later diagnosed with schizophrenia. 15. According to the Royal College of Psychiatrists, over 80% of depressed patients who receive ECT respond well to it.
Due to the fact that patients getting ECT may be having 2-3 treatments per week for a number of weeks, this confusion can accumulate over time so that much of the period of time represented by the course of ECT may remain foggy.
ECT is the most effective treatment for biological depression and in many cases , the more severe the depression, the more likely it is that ECT will work. Response rates for an uncomplicated depression can be as high as 90%. For refractory depressions (those that haven’t responded to conventional medication treatment), the response rate is still in the 70-80% range in many studies. For depression where the diagnosis is less clear or particularly where there may be a combination of diagnoses, ECT may still be effective against depressive symptoms but the response rate is significantly lower (50-60%) and the response is often less satisfying to the patient. ECT has always been relatively safe. Now that the procedure has evolved (like most other treatments in medicine), we are able to administer the treatments in a way that is not particularly stressful for the patient, making it an increasingly sought after treatment.
ECT is a medical procedure that is done in the Outpatient Procedures area at UNC Hospitals utilizing many of the same anesthesiologists and nurse anesthetists who work in the UNC operating rooms. The procedure involves a ‘light’ anesthesia using a short-acting anesthetic agent such as methohexital or propofol.
What is ECT? Stated simply: ECT is the application of a small amount of electricity (electro-) to the human brain to generate a brief grand-mal seizure (convulsive). The procedure (therapy) is done while the person is anesthetized and the muscles are relaxed.
Side effects of ECT can be divided into those due to the anesthesia and those due to the treatment itself. Nausea is sometimes seen as a result of sensitivity to the anesthetic agents used. Muscle aches from the paralytic agents is not uncommon as well. Post treatment sedation is of course not unexpected.
We can measure neurochemical and physiological changes in the brain after a response to ECT, which are similar to the changes seen in patients who respond to antidepressant medications.
Bilateral versus Unilateral ECT. Refers to the placement of the stimulus electrodes on a patient’s scalp (which directs the current path). In traditional bilateral ECT, the electrodes are placed on the right and left temples, allowing simultaneous stimulation of both sides of the brain.
This typically means psychotherapy and/or medication or, in some circumstances, ongoing ECT treatments.
A patient typically receives ECT two or three times a week for a total of six to 12 treatments, depending on the severity of symptoms and how quickly the symptoms respond to the treatment.
ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia. It is typically administered by a team of trained medical professionals that includes a psychiatrist, an anesthesiologist, and a nurse or physician assistant.
What is Electroconvulsive therapy (ECT)? 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 involves a brief electrical stimulation of the brain while the patient is under anesthesia.
TMS is usually administered four or five times a week for four-to-six weeks. Vagus Nerve Stimulation (VNS) was developed as a treatment for seizure disorders but can also be used to treat depression that has not responded to other therapies.
The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours.
Before beginning a series of ECT treatments, a patient should receive a thorough psychiatric assessment, including a medical examination and sometimes a basic blood test and an electrocardiogram (ECG) to check heart health.
ECT is often used when other kinds of treatment haven’t worked. ECT is given in a series of treatments, several times a week. The number of treatments depends on how severe the patient’s symptoms are. Usually, 6 to 12 treatments are needed. It is generally considered safe and effective.
This causes changes in the brain that can improve and even reverse troubling symptoms. These symptoms could include severe depression, mania, or aggression. ECT is often used when other kinds of treatment haven’t worked.
You’ll wake up from the anesthesia in 5 to 10 minutes. You will be taken to a recovery room and monitored. After about an hour, you can go home. You won’t remember the treatment, and you may be confused for a short time. ECT is typically given one time every 2 to 5 days for a total of 6 to 12 sessions.
The electric current will pass through the electrodes and into your brain for 1 or 2 seconds. This will cause a seizure that usually lasts less than 1 minute. Because you are asleep and your muscles are relaxed, there are few signs that you are having a seizure. Your body doesn’t move and you don’t feel anything.
Electroconvulsive therapy (ECT) is a method of stimulating the brain with electricity to treat some types of severe mental illness. It can be used to treat brain disorders as well. The procedure sends small electric currents through the brain.
ECT is generally safe , but as with most treatments, it has risks and side effects. Short-term memory loss is common. You may have trouble remembering things from the time surrounding the treatment. This usually gets better a few weeks after treatment has ended.
Doctors conduct ECT in a hospital. You may receive it during a hospital stay. Or you can go to a hospital just for the treatment and then go home. Before each treatment, a doctor will give you an intravenous (IV) line. This allows medicine to be injected directly into your blood.
Typically, 70 to 120 volts are applied externally to the patient's head resulting in approximately 800 milliamperes of direct current passed through the brain, for 100 milliseconds to 6 seconds duration, either from temple to temple (bilateral ECT) or from front to back of one side of the head (unilateral ECT).
Electroconvulsive therapy machine on display at Glenside Museum in Bristol, England. ECT device produced by Siemens and used for example at the Asyl psychiatric hospital in Kristiansand, Norway from the 1960s to the 1980s.
As of 2012, there are approximately 400 ECT machines in China, and 150,000 ECT treatments are performed each year. Chinese national practice guidelines recommend ECT for the treatment of schizophrenia, depressive disorders, and bipolar disorder and in the Chinese literature, ECT is an effective treatment for schizophrenia and mood disorders. Although the Chinese government stopped classifying homosexuality as an illness in 2001, electroconvulsive therapy is still used by some establishments as a form of " conversion therapy ".
There is little agreement on the most appropriate follow-up to ECT for people with major depressive disorder. When ECT is followed by treatment with antidepressants, about 50% of people relapsed by 12 months following successful initial treatment with ECT, with about 37% relapsing within the first 6 months.
ECT is used to treat people who have severe or prolonged mania; NICE recommends it only in life-threatening situations or when other treatments have failed and as a second-line treatment for bipolar mania.
ECT became popular in the US in the 1940s. At the time, psychiatric hospitals were overrun with patients whom doctors were desperate to treat and cure. Whereas lobotomies would reduce a patient to a more manageable submissive state, ECT helped to improve mood in those with severe depression. A survey of psychiatric practice in the late 1980s found that an estimated 100,000 people received ECT annually, with wide variation between metropolitan statistical areas. Accurate statistics about the frequency, context and circumstances of ECT in the US are difficult to obtain because only a few states have reporting laws that require the treating facility to supply state authorities with this information. In 13 of the 50 states, the practice of ECT is regulated by law. In the mid-1990s in Texas, ECT was used in about one third of psychiatric facilities and given to about 1,650 people annually. Usage of ECT has since declined slightly; in 2000–01 ECT was given to about 1500 people aged from 16 to 97 (in Texas it is illegal to give ECT to anyone under sixteen). ECT is more commonly used in private psychiatric hospitals than in public hospitals, and minority patients are underrepresented in the ECT statistics. In the United States, ECT is usually given three times a week; in the United Kingdom, it is usually given twice a week. Occasionally it is given on a daily basis. A course usually consists of 6–12 treatments, but may be more or fewer. Following a course of ECT some patients may be given continuation or maintenance ECT with further treatments at weekly, fortnightly or monthly intervals. A few psychiatrists in the US use multiple-monitored ECT (MMECT), where patients receive more than one treatment per anesthetic. Electroconvulsive therapy is not a required subject in US medical schools and not a required skill in psychiatric residency training. Privileging for ECT practice at institutions is a local option: no national certification standards are established, and no ECT-specific continuing training experiences are required of ECT practitioners.
Neuroimaging prior to ECT may be useful for detecting intracranial pressure or mass given that patients respond less when one of these conditions exist . Nonetheless it is not indicated due to high cost and low prevalence of these conditions in patients needing ECT.
Most patients require 6 to 12 total treatments . People may still be depressed after 12 treatments and may require more. Every person is an individual and the total number of treatments may be more. Cutting someone off after a dozen treatments and then having them commit suicide because they were still depressed would not be a good outcome.
Often ECT will work well for those with severe or atypical depression when nothing else has. It is also much more effective for patients over 60 years of age.
Oral trauma and Lip issues: When the electrodes go off, even when muscles are paralyzed, jaw muscles bite down with full strength. We place this in the mouth.
Heart Rate and Blood Pressure issues: Seizures are like an electric storm in your brain. Your brain is wired to your heart. Some crazy stuff goes on in patient’s hearts rhythm-wise, and BP shoots up as well during ECT. We give some beta-blocker and generally just wait to send them home until they are back within a safe range again. When they come back for another treatment we pre-treat them with Labetolol (a blood pressure med) to prevent it from happening again.
In the case of unilateral ECT an electrode is attached to the top of your head as well as one temple . Bilaterally electrodes are attached to both temples and nowhere else.
ECT’s are becoming mercifully rare at least where I work. Newer technologies like Transcranial Magnetic Stimulation (TMS) and Vagal Nerve stimulators and Ketamine therapy are growing in use. I hope they are as useful as ECT without my having to be involved as an Anesthesiologist.
I would guess maybe a third have some degree of memory issue for longer term but it seems to come back over time. Most patients seem not terribly concerned by this. Patients and families seem more worried about resolving their depression. Depression of this severity generally takes them out of whatever job they were doing so I can’t speak for folks with jobs that require a lot of memory.