Electroconvulsive Therapy (ECT)


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Electroconvulsive Therapy (ECT)

  1. 1. Electroconvulsive Therapy (ECT)<br />Tammy Lee<br />IB Psychology<br />
  2. 2. History of ECT<br />Ancient Times<br />Electric eels and fish were used for headaches and mental illness.<br />1936<br />Based on findings by Hungarian psychiatrist that epilepsy and schizophrenia have opposite effects<br />Theory that inducing epileptic seizure in schizophrenic person could alter brain chemistry enough to alleviate symptoms<br />Used drugs to induce seizures and seemed to work<br />UgoCerletti and LucinoBini<br />Experiment on animals to investigate epilepsy and find that electricity is more efficient in inducing seizures.<br />Kill many animals by placing electrodes on either end of animal.<br />Bini realizes that placing electrodes on sides of the head prevents heart damage.<br />
  3. 3. History of ECT (cont’d)<br />1938<br />Cerletti and Bini apply electroshock to first human patient.<br />Very successful<br />Extremely schizophrenic man is able to live normally with this new therapy.<br />1930s & 1940s<br />ECT becomes a very popular treatment.<br />Accepted readily because no better alternatives and high demand (like lobotomies)<br />1950s<br />Arrival of Thorazine<br />Medication for treating schizophrenia<br />ECT becomes 2nd choice/last resort<br />Current Day<br />has regained popularity<br />Technological advancement  decreased risk<br />100,000+ Americans treated with ECT yearly<br />10 to 20 times this number worldwide<br />
  4. 4. Usage<br />ECT is used to treat:<br />Severe depression<br />Accompanied by<br /><ul><li>psychosis
  5. 5. Catatonic stupor
  6. 6. Suicidal intent
  7. 7. Refusal to eat</li></ul>Mania<br />That hasn’t improved with medications<br />Schizophrenia<br />When medications are insufficient or symptoms are severe<br />
  8. 8. Procedure<br />Time: 10-15 <br />+time for prep & recovery<br />Intravenous (IV) catheter is inserted in the arm or hand<br />Oxygen mask may be given<br />Electrodes are placed on the head<br />Unilateral: one side receives electricity<br />Bilateral: both sides<br />Anesthetic is injected into IV.<br />Unconscious and unaware of procedure<br />Muscle relaxant is injected into IV.<br />Prevent violent convulsions<br />Blood pressure cuff placed around forearm or ankle<br />Prevents muscle relaxant from paralyzing, so doctor can confirm seizure with movement of hand/foot<br />Electric current is sent through electrodes to brain.<br />Seizure lasts 30-60 sec.<br />Few minutes later, anesthetic and muscle relaxant wear off.<br />
  9. 9. Risks & Side Effects<br />Impairment of Cognition<br />Period of confusion immediately after ECT<br />May not know where you are or why you are there<br />Generally lasts few min. to several hrs.<br />Memory Loss<br />May forget weeks/months before treatment, during treatment, or after treatment has stopped<br />Usually improves within couple of months<br />Permanent in relatively rare cases<br />Medical Complications<br />Heart problems<br />Small risk of death<br />same as other procedures using anesthesia<br />Physical Symptoms<br />Nausea<br />Vomiting<br />Headache<br />Muscle ache<br />Jaw pain<br />
  10. 10. ECT in the Media<br /><ul><li>One Flew Over the Cuckoo’s Nest (1975)
  11. 11. Portrayed as primitive and ineffective instrument for social control</li></ul>Strongly influential in affecting a public disapproval of ECT<br />Girl, Interrupted (1999)<br />Lisa runs away because of “shocks” given to her.<br />Films present inaccurately negative representations of modern-day ECT.<br />
  12. 12. Effectiveness & Controversy<br />80% success rate (APA)<br />vs. 50-60% success rate of most antidepressants<br />Thing of the Past<br />Many people still believe that ECT is still the crude and painful procedure it was half a century ago.<br />Opponents believe ECT is barbaric and outdated.<br />Effectiveness vs. Side Effects<br />Risk of permanent cognitive impairment and memory loss <br />Some studies find that relapse is high, even for patients who take medications afterwards.<br />Some researchers insist that no study proves that ECT is effective for more than 4 weeks.<br />
  13. 13. Conclusion: Why ECT is Important<br />Despite its stigma, ECT is still practiced fairly commonly to this day. <br />ECT is much safer than before due to the precision in administering electric currents offered by modern-day technology, which minimizes sides effects. <br />Complications, such as memory loss, still arise in patients who are treated with ECT, and this causes many people to oppose it.<br />Notwithstanding the controversy, ECT has the highest success rate of any other treatment for Major Depressive Disorder and is a plausible option for individuals suffering from severe forms of this illness.<br />
  14. 14. Philadelphia Area Resources<br />Belmont Behavioral Health<br />4200 Monument Rd<br />Philadelphia, PA 19131<br />(215) 877-2000<br />Friends Hospital<br />4641 Roosevelt Blvd<br /> Philadelphia, Pa 19124<br />(215) 831-4600<br />Pennsylvania Hospital<br />800 Spruce St<br /> Philadelphia, Pa 19107<br />(215) 829-3000<br />
  15. 15. Sources<br />http://www.pbs.org/wgbh/aso/databank/entries/dh38el.html<br />http://psychcentral.com/lib/2006/an-overview-of-electroconvulsive-therapy-ect/<br />http://www.mayoclinic.com/health/electroconvulsive-therapy/MY00129/DSECTION=why%2Dits%2Ddone<br />http://www.psychiatrictimes.com/web/10168/login<br />http://www.electroboy.com/electroshocktherapy.htm<br />http://www.mayoclinic.com/health/electroconvulsive-therapy/MY00129<br />http://www.nmha.org/go/information/get-info/treatment/electroconvulsive-therapy-ect<br />http://www.medhelp.org/lib/ect.htm<br />http://www.shockmd.com/wp-content/ect-0903-13.jpg<br />http://cristinalaird.files.wordpress.com/2009/06/depression.jpg<br />http://www.ccp.edu/vpst-aff/studentlife/Career%20Services/question-mark_cartoon.jpeg<br />http://trinitypastor.files.wordpress.com/2008/12/nicholson.jpg<br />http://friendshospital.com/about/mission_statement/<br />One Flew Over the Cuckoo’s Nest (1975)<br />Girl, Interrupted (1999)<br />Shock: The Healing Power of Electroconvulsive Therapy (2006) by Kitty Dukakis and Larry Tye<br />