1. ELECTRO
CONVULSIVE
THERAPY
BY
MARYYAM ALI
FINAL YEAR

2. DEFINITION;
• It is the production of a generalized
central nervous system seizure
produced by means of an electric
current.

3. PRINCIPLE;
• It is to exceed the main seizure
threshold , which here is accomplished by
electric current.
• If this threshold is not exceeded the
treatment fails.

4. MODE OF ACTION;
• Not well understood.
• In animal studies , however , it has been
noticed to increase the sensitivity of norepinephrine and serotonin receptors.

5. INDICATIONS FOR ECT;
• 70-85% Effective in treatment of severe
depression , particularly when agitation and
delusion are present with it. In addition in
patients with;
with suicidal tendency,
delay in treatment is a
risk to health,
refusal
to drink and eat,
depressive stupors,
antidepressants are
cotraindicated/nonresponsive.

6. OTHER INDICATIONS ARE;
•
•
•
Manic disorders and psychosis in pregnancy.
Chronic schizophrenia.
Acute schizophrenia , not generally only
when;
drugs are un-effective, or
urgent need of treating the
psychosis.
• In elderly patients with risks of s/e of drugs.

7. METHOD OF ECT;
• Anesthesia:
given by I/V short acting anesthetic
(THIOPENTAL 125-150mg)---for sleep,
and a muscle relaxant
(SUXAMETHONIUM
30-50mg).
• Application of electrodes to brain:
BILATERALLY/UNILATERALLY.
• Dose:
80V for 100-300ms 4-8times for 3-4wks.

8. METHOD OF ECT (contd.)
• Treatment after ECT:
manage patients
headache,
IMIPRAMINE (Tricylic
antidepressant) for few months to
decrease relapses.

9. SIDE EFFECTS;
• Transient memory loss depending upon , No.
•
•
•
and frequency of ECT,
Oxygenation during ECT with anesthesia,
Use of LITHIUM with ECT (previously).
Headache for few hrs to a day or so.
Defects in new learning in few people.
Anticipatory anxiety.
(GENERALLY THESE SIDE EFFECTS ARE
SEEN IN THOSE WITH INEFFECTIVE ECT)

10. PREVIOUSLY SEEN SIDE
EFFECTS;
• Before anesthesia was used in ECT;
spinal
compression fractures were common.

11. COMPLICATIONS;
• In 1/1000 cases cardiovascular or
respiratory complications develop.
• These complications are preventable if
contraindications are kept under
consideration , along with care during
anesthesia.

12. CONTRAINDICATIONS;
•
•
•
•
•
Increase intra cranial pressure.
Cardiac diseases.
Aortic aneurysm.
Bronchopulmunary disease.
Venous thrombosis.

13. OBSTACLES;
• Poor public understanding.
• Lack of acceptance of the
technique.