ECT, current practice

45
Shocken waarom nog? W.W. van den Broek

description

Slides for lecture on ECT for lay public during the Publieksdag on the Annual Conference of the Dutch Association of Psychiatry 2011

Transcript of ECT, current practice

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Shocken waarom nog?W.W. van den Broek

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Happiness is nothing more than good health and a

bad memory.

”Albert Schweitzer

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Depressie

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2/3

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De veertiger jaren

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De jaren negentig

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ECT Nu

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Wat gebeurt er eigenlijk?

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Screening

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Voorlichting

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Voorbereiding

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Risico groepen

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Uitvoering

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Anesthesie

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Rechts Unilaterale Elektrodeplaatsing d’Elia

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Bilaterale elektrodeplaatsing

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Bifrontale elektrodeplaatsing

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Dosering

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Waarom is de pulsbreedte belangrijk?

Elektrodeplaatsing Pulsbreedte Remissie (%)

RUL 0.3 msec 73%

RUL 1.5 msec 59%

BL 0.3 msec 35%

BL 1.5 msec 65%

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Behandelduur en behandelfrequentie

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Bijwerkingen

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Acute bijwerkingen

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Retrograde amnesieMemory.uva.nl

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0

0.1

0.2

0.3

0.4

month 1-3 month 4-6 month 7-9 month 10-12

Pro

po

rtio

n r

ecal

led

Time in months relative to test

matched ctrlpre-ectpost ectfollow-up

Resultaten Retrograde amnesie

Before

After

Follow-up

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Anterograde amnesie

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Results: AA

Mean 10 WT performance (max. 30)

10

15

20

pre-ect post-ect follow-up

*

***

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Hoe nu verder?

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Nabehandeling

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Vervolg-ECT

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Transparantie en contoleerbaarheid geleerd uit het verleden

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“Visitatiemodel van belang, niet alleen voor waarborging van de kwaliteit maar ook voor een grote mate van transparantie voor uitvoerders en patient in het bijzonder, en de maatschappelijke context in het algemeen. Richtlijn ECT 2010

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Visitatie en registratie

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www.shockmd.com