Ect and Its Benefits
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Transcript of Ect and Its Benefits
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INTRODUCTIONy Formerly known as electroshock.
y ECT is most often recommended for use as a treatment
for severe depressions which has not responded toother treatment.
y It was first introduced in 1938 and gained widespreaduse as a form of treatment in the 1940s and 1950s
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Early Theoriesy Hippocrates: Documented the cure of insane patient
following malaria-induced seizures.
y Swiss physician Paracelsus in 1500s, induced seizureswith oral camphor to treat mania and psychosis.
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Electrically induced Seizuresy In 1937, Italian physicians Cerletti & Bini applied
electricity to head to induce therapeutic seizures.
y
First patient had catatonia and he improved.y Safer than chemically induced seizures.
yWidespread acceptance through out Europe and USA.
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y Electroconvulsive therapy can differ in its applicationin three ways:
electrode placement
frequency of treatments
the electrical waveform of the stimulus
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yAfter treatment, drug therapy is usually continued,and some patients receive continuation/maintenance
ECT.
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The Benefits of ECTy Half those who remit then relapse within six months
y discontinuing antidepressant medication
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Probability ofremissiony 1999
y both clinical experience and published studies had
determined ECT to be effectivey 60%-70%
y depression, some acute psychotic states, and mania
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y 2004
y New Yorkdescribing itself as the first systematic
documentation of the effectiveness of ECT incommunity practice in the 65 years of its use
y found remission rates of only 30%-47%, with 64% ofthose relapsing within six months.
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y However, when patients with co-morbid personalitydisorders or who were suffering from schizoaffective
disorder were removed from the analysis, theremission rates climbed to 60%-70%.
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Degree of effectivenessy ECT is effective in the treatment of depression.
y 2003
y The UK ECT Review group published a systematicreview and meta-analysis comparing ECT to placeboand antidepressant drugs.
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y 2006, research psychiatrist Colin A. Ross reviewed theplacebo-controlled trials one-by-one and found that
no single study showed a significant differencebetween real and placebo ECT at one month post-treatment.
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y 2010 (Bentall and Read)
y Their conclusions are as follows: Given the strong
evidence of persistent and, for some, permanent braindysfunction, primarily evidenced in the form ofretrograde and anterograde amnesia, and the evidenceof a slight but significant increased risk of death, the
cost-benefit analysis for ECT is so poor that its usecannot be scientifically justified.
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Related experimental therapeuticsy Recent research has investigated whether implantable
devices such as DBS (deep brain stimulation) could
result in clinical improvements for patients withtreatment-resistant depression. However, in NorthAmerica, DBS has not been authorized as an approved,effective therapy for treatment-resistant depression.
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CONCLUSION
The effects of using ECT can often
be gained almost immediately.
M
any patients have reportedfeeling less depressed after theirvery first series of shocks