Electroconvulsive Therapy

Review the outline in notes

Electroconvulsive Therapy (ECT)• ECT is the induction of a grand mal (generalized) seizure

through the application of electrical current to the brain.• Stimulus is applied through electrodes placed bilaterally

in the frontotemporal region or unilaterally on the same side as the dominant hand.

• Dose of stimulation is based on the client’s seizure threshold, which is highly variable among individuals.

• The duration of the seizure should be at least 25 seconds.• Usually administered every other day, for three times per

week; most clients need 6 to 12 treatments.

Indications• ECT has been shown to be effective in the treatment of

severe depression. It is usually not considered the treatment of choice for depression but may be administered after a trial of therapy with antidepressant medication.

• ECT is also indicated in the treatment of acute manic episodes of bipolar affective disorder. It has been shown

to be effective in treating manic clients who are refractory to antimanic drug therapy.

• ECT can induce a remission in some clients who are diagnosed with acute schizophrenia, but it seems to be of little value in the treatment of chronic schizophrenia.

Contraindications

• The only absolute contraindication for ECT is increased intracranial pressure (from brain tumor, recent CVA, or other cerebrovascular lesion).

• Individuals at high risk with ECT include those with myocardial infarction or cerebrovascular

accident within the preceding 3 months, aortic or cerebral aneurysm, severe underlying hypertension, and congestive heart failure.

Side Effects

• The most common side effects are temporary memory loss and confusion.