How many ECT treatments can you have in a week?
The ECT taper from an acute series to a maintenance schedule is generally once a week for 4 treatments, then every 2 weeks for 4 treatments, then every 3 weeks for 4 treatments, then every 4 weeks. There is no limit on how long a patient can receive maintenance ECT provided the treatment is effective.
How long does an ECT session take?
An ECT session takes about one hour total. There is time for patient assessments before treatment, receiving treatment (20 minutes), resting in the recovery area (20 minutes), and getting transferred back to a unit (inpatient) or to the driver's vehicle (outpatient).
What is the difference between electroconvulsive therapy (ECT) and ongoing treatment?
Ongoing treatment may be ECT with less frequency, but more often, it includes antidepressants or other medications, or psychological counseling (psychotherapy). What is electroconvulsive therapy (ECT)?
How long does maintenance ECT last?
Maintenance ECT involves getting treatments every two weeks to every month, usually for a period of six months to a year. But patients have gone on maintenance ECT for up to three years, depending on their response.
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Are ECT patients NPO?
To get ready for the ECT procedure: You'll have general anesthesia. So you can expect dietary restrictions before the procedure. Typically, this means no food or water after midnight and only a sip of water to take any morning medications.
Should you avoid eating before ECT?
8 hours before you get ECT, stop eating and drinking anything except water and black coffee (no cream or sugar). 2 hours before ECT, stop drinking. Do not wear any lotion, oil, cologne, perfume, make-up, or colored nail polish.
What should you not do before ECT?
There are reports of certain complementary medications such as ginkgo biloba, ginseng, St John's wort, valerian and kava kava interfering with ECT. 35 Given the lack of evidence of efficacy of these medications, it is advisable to cease these supplements prior to commencement of ECT as the risks outweigh the benefits.
Why do you have to fast before ECT?
Fasting is important to prevent complications during ECT. If you have food or fluid in your stomach when you are under anaesthetic this may cause you to vomit and become unwell. It is also important not to fast for too long as this is unnecessary and can make you feel worse, affecting your treatment experience.
Can you eat prior to ECT therapy?
Before ECT, patients are asked not to eat or drink from midnight the night before treatment. During the procedure, the patient receives a short acting anesthetic agent which puts the patient to sleep for approximately 5-10 minutes.
How do you prepare for ECT?
Before Your Procedure Because electroconvulsive therapy is performed under general anesthesia, you should not eat, drink, or smoke after midnight on the days of your treatments. Do not drink alcohol or use any illegal drugs over the course of the treatment.
Which of the following is a contraindication of ECT?
While there are no absolute contraindications to ECT, several relative contraindications exist. These include recent MI or stroke (generally within the last 30 days), increased intracranial pressure, active bleeding (especially from the central nervous system), retinal detachment, and unstable dentition.
Why is atropine given before ECT?
Atropine treatment before electroconvulsive therapy (ECT) is used for two main reasons: a) to prevent transient post-ictal bradyarrhythmias due to excessive vagal tone; b) to minimize secretions within the respiratory tract.
When should ECT not be used?
The following strategies should not be used routinely: augmentation of an antidepressant with a benzodiazepine for more than 2 weeks as there is a risk of dependence. augmentation of an antidepressant with buspirone*, carbamazepine*, lamotrigine* or valproate* as there is insufficient evidence for their use.
How long do you have to fast before ECT?
You must fast from midnight before your treatment. Do not eat, drink, smoke, suck on lollies or chew gum six hours prior to treatment, this is to make sure your stomach is empty so that if you vomit under the anaesthetic there will be nothing to go up into the lungs.
Are you intubated for ECT?
Patients are not intubated for ECT, except under extremely rare circumstances. An intravenous line is inserted in the patient's arm, through which the anesthetic and muscle relaxant medications are administered.
How long is ECT treatment?
Maintenance ECT involves getting treatments every two weeks to every month, usually for a period of six months to a year. But patients have gone on maintenance ECT for up to three years, depending on their response.
How often do you get ECT?
In the United States, ECT treatments are generally given two to three times weekly for three to four weeks — for a total of six to 12 treatments. Some doctors use a newer technique called right unilateral ultrabrief pulse electroconvulsive therapy that's done daily on weekdays.
How long after ECT can you drive?
However, some people may be advised not to return to work, make important decisions, or drive until one to two weeks after the last ECT in a series, or for at least 24 hours after a single treatment during maintenance therapy.
What is ECT in medical terms?
Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.
Why is electroconvulsive therapy used?
Why it's done. Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat: Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. Treatment-resistant depression, ...
What is ECT used for?
ECT is used to treat: Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. Treatment-resistant depression, a severe depression that doesn't improve with medications or other treatments. Severe mania, a state of intense euphoria, agitation or hyperactivity ...
Is it safe to take ECT?
Risks. Although ECT is generally safe, risks and side effects may include: Confusion. Immediately after treatment, you may experience confusion, which can last from a few minutes to several hours. You may not know where you are or why you're there. Rarely, confusion may last several days or longer.
What is ECT treatment?
The ECT treating team requests the family’s feedback in assessing a patient’s improvement. Families can assist with transportation and supportive care after ECT. Families commonly are able to see progress in the patient’s activity before the patient actually feels better.
What is the night before ECT?
The night before ECT, patients are asked not to eat or drink anything after midnight and until after their ECT treatment the following day is completed. The morning of ECT, patients arrive to the waiting area and generally complete a clinical survey. The patient enters the ECT suite and meets with the ECT nurse, psychiatrist, and anesthesiologist.
What is maintenance ECT?
Maintenance ECT is for patients who cannot remain well after an acute course of ECT. Generally, we will offer an acute series of ECT only. Many patients remain well while staying on antidepressant therapy, such as nortriptyline and lithium.
How often does ECT taper?
The ECT taper from an acute series to a maintenance schedule is generally once a week for 4 treatments, then every 2 weeks for 4 treatments, then every 3 weeks for 4 treatments, then every 4 weeks. There is no limit on how long a patient can receive maintenance ECT provided the treatment is effective.
How long can you drive after ECT?
Patients are not allowed to drive during the entire ECT course and for 2 weeks after the last treatment in an acute series of ECT. An acute series is usually 3 treatments a week for 6 to 12 treatments. Patients who receive maintenance ECT can drive except on the day of ECT.
How does ECT work?
ECT appears to increase neurotransmitters, such as serotonin and dopamine. ECT also increases BDNF, brain derived neurotrophic factor , which can help the brain cells grow.
What is ECT used for?
ECT is used in people with treatment-resistant depression, mania, and psychosis from schizophrenia. Most people are receiving ECT for treatment-resistant depression, when antidepressant medication and psychotherapy have not worked.
How long can you be on maintenance ECT?
Maintenance ECT involves getting treatments every two weeks to every month, usually for a period of six months to a year. But patients have gone on maintenance ECT for up to three years, depending on their response. ...
How many treatments are there for ECT?
Typically the ECT treatment course lasts eight to 12 treatments -- sometimes as few as six, sometimes as many as 15 treatments can occur in a course. Your doctor will determine how many you need depending on your response. After patients have received a course of ECT they're usually placed back on medication.
How long does it take for a patient to get back on medication after ECT?
After patients have received a course of ECT they're usually placed back on medication. However patients given medication after ECT have about a 50/50 chance of relapsing or having another episode of depression. Usually this episode occurs within one to three months after ECT -- but it can occur within the six months after ECT. ...
How many times a week is electroconvulsive therapy?
Email this article. — -- Question: How long will I need to do electroconvulsive therapy (ECT), and what is maintenance ECT? Answer: ECT is usually given two or three times a week -- usually on Monday, Wednesday, and Friday. Typically the ECT treatment course lasts eight to 12 treatments -- sometimes as few as six, ...
What is ECT therapy?
WHAT YOU NEED TO KNOW: Electroconvulsive therapy (ECT) is a treatment that sends an electric current to your brain to cause a seizure. The seizure affects the chemicals in your brain, which may make your brain cells work better.
Can ECT cause headaches?
You may be confused or have trouble remembering things. You may have nausea, vomiting, a headache, or muscle aches. Your blood pressure may increase, or your heart rhythm may change. You may need more than one session. ECT may not improve your symptoms.
What to expect before ECT?
What to expect before the ECT treatment? Before your first ECT procedure, your doctor will go through a variety of assessment to make sure you are eligible for ECT and that it will be safe for you. These may include (1,3) : A complete psychiatric history.
What happens if you don't give consent to ECT?
If you are not able to give consent, then the doctor will request for consent from your substitute decision maker. This person may be your spouse, children, parents or other family members that would be able to make a decision on your behalf ...
What medications affect the effectiveness of ECT?
Review of medications. Some medications (ex: lithium, benzodiazepines, theophylline, seizure medications ) may affect the effectiveness or safety of ECT and should be carefully considered. Chest X-ray. The doctor may order a chest x-ray to assess the health of your heart and lungs.
What should be considered when administering ECT?
The decision to administer ECT should include consideration of the anticipated effects of the patient’s medical status, including present medical treatments, upon the risks and benefits of ECT.
What is ECT treatment?
Primary Use: ECT is a major treatment in psychiatry with well-defined indications. It should not be reserved for use only as a “last resort”. The likely speed and efficacy of ECT are factors that influence its use as a primary intervention. Particularly in major depression and acute mania, substantial clinical improvement often occurs soon after the start of ECT. When a rapid or a higher probability of response is needed, as when patients are severely medically ill or at risk to harm themselves or others, primary use of ECT should be considered. Other considerations for the first-line use of ECT involve the patient’s medical status, treatment history, and treatment preference.
What should be assessed prior to each ECT?
Orientation and memory function should be assessed prior to each ECT and periodically throughout the ECT course to monitor the presence of ECT-related cognitive dysfunction. Based on the severity of the cognitive side effects, the physician administering ECT should consider alteration of the ECT technique and reconsideration of medications the patient is taking.
How long has electroconvulsive therapy been used?
Electroconvulsive Therapy has been in continuous use for more than 60 years. The clinical literature establishing its efficacy in specific disorders is among the most substantial for any medical procedure. The decision to recommend the use ECT derives from a risk/benefit analysis for the specific patient. This analysis considers the diagnosis of the patient and the severity of the presenting illness, the patient’s treatment history, the anticipated speed of action and efficacy of ECT, the medical risks and anticipated adverse side effects. These factors should be considered against the likely speed of action, efficacy, and medical risks of alternative treatments in making a determination to use ECT. These Guidelines are taken from the APA Guidelines published in November 2000, which should be reviewed for further details.
Can elderly people take ECT?
ECT may be used with elderly regardless of age. Efficacy does not diminish with age, and may be enhanced. Clinical experience suggests that among the elderly, ECT may have less risk of complications than some forms of pharmacotherapy.
Can you discontinue antipsychotics before ECT?
All medications should be reviewed as part of the pre-ECT evaluation. In general, it is advisable to discontinue or reduce the dose of most psychotropic agents prior to ECT, although this should not prevent the institution of ECT treatment in a timely fashion. This is especially true for medications that may increase morbidity or decrease efficacy of ECT (i.e. benzodiazepines and most sedative hypnotics, anticonvulsants, lithium). Patients on antidepressants may continue the course of therapy, as co-administration of moderate doses of antidepressant is unlikely to contribute substantially to morbidity. There may even be a synergistic effect with the co-administration of antipsychotic medication and ECT.
Overview
Why It's Done
Self help information for family, friends and colleagues
- Loosen tight clothing
- Protect the person from injury
- If they have fallen, place something soft under their head
- Stay with them until they recover fully
Do not:
- Try to restrain the person
- Put anything between their teeth
- Move them, unless they are in danger
- Give them food to eat or drink
Person who have had seizure
- Avoid triggers
- Avoid unprotected heights and unsupervised areas of water
- Seizure lasts less than 5 minutes
- None of the below mentioned incidents occur during the episode
See a doctor immediately if you notice:
- Seizure lasts longer than five minutes
- Breathing or consciousness doesn't return after the seizure stops
- A second seizure follows immediately
- The seizure happened in water
- High fever
- Heat exhaustion
- Person is pregnant
- Person has diabetes
- Person is injured during the seizure
Risks
How You Prepare
- No one is sure how ECT helps certain psychiatric disorders. It may promote changes in how brain cells communicate with each other at synapses and it may stimulate the development of new brain cells. ECT may flood the brain with neurotransmitters such as serotonin and dopamine, wh…
What You Can Expect
Results
Uses
Diagnosis
Risks
Prognosis
- Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat: 1. Severe depression,particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. 2. Treatment-resistant depression,a severe depression that doesn't improve with medications o…
Scope
- Although ECT is generally safe, risks and side effects may include: 1. Confusion.Immediately after treatment, you may experience confusion, which can last from a few minutes to several hours. You may not know where you are or why you're there. Rarely, confusion may last several days or longer. Confusion is generally more noticeable in older adults. 2. Memory loss.Some people hav…
Preparation
- Before having your first ECT treatment, you'll need a full evaluation, which usually includes: 1. Medical history 2. Complete physical exam 3. Psychiatric assessment 4. Basic blood tests 5. Electrocardiogram (ECG) to check your heart health 6. Discussion of the risks of anesthesia These exams help make sure that ECT is safe for you.
Treatment
- The ECT procedure takes about five to 10 minutes, with added time for preparation and recovery. ECT can be done while you're hospitalized or as an outpatient procedure.
Purpose
- Many people begin to notice an improvement in their symptoms after about six treatments with electroconvulsive therapy. Full improvement may take longer, though ECT may not work for everyone. Response to antidepressant medications, in comparison, can take several weeks or more. No one knows for certain how ECT helps treat severe depression and other mental illness…
Composition
- ECT may be considered as a primary treatment (or first-line treatment) for persons exhibiting syndromes such as: severe major depression, acute mania, mood disorders with psychotic features, and catatonia. A decision to use ECT as the primary therapy should be based on an evaluation of the nature and the severity of acute symptoms in conjunction with an evaluation o…
Administration
- Guidelines: Providers should identify principal diagnostic indications and other diagnostic indications for the use of ECT. When identifying persons for possible ECT, a current psychiatric evaluation and diagnosis should be part of the required procedures. Even when no mental illness is diagnosed, other diagnostic indications may include medical disorders such as: Parkinsons di…
Roles
- Coexisting medical illnesses (e.g. neurologic and cardiovascular disorders) and their treatment may affect both the likelihood of response and the risks of ECT. It is critical to recognize potential interactions among coexisting medical conditions, physiologic events associated with anesthesia, electrical stimulation, and induced seizure activity when proposing and administering ECT. Limit…
Staff
- Elderly patients may receive ECT regardless of age. The efficacy of treatment does not diminish with advancing age. ECT may have a lower risk of complications than some forms of pharmacotherapy in the elderly. Pregnant women and nursing mothers may receive ECT during all trimesters of pregnancy, puerperium and nursing. ECT may be less risky than al...
Management
- Guidelines: Providers should address special populations of patients who may receive ECT treatment. OMH recognizes that hospitals/facilities may provide ECT services to other special populations (e.g. mental retardation/developmental disabilities) in addition to the ones specifically identified by the APA. Facilities providing ECT to a special population should develo…
Equipment
- Providers should require an evaluation of a patients condition prior to ECT to determine whether they should be considered as a member of a special population. For patients who are identified as belonging to a special population, a tailored risk/benefit assessment should be completed by appropriate medical professionals. Pregnant patients should receive an obstetric consultation p…
Safety
- Any modifications to the standard ECT treatment regimen must be clinically documented at the time of ECT. For example, persons with substantial symptoms of neurologic disorders (e.g. NMS) or persons at risk of hyperkalemia may require nondepolarizing muscle relaxants instead of succinylcholine and persons with porphyria should receive a nonbarbiturate anesthetic.
Assessment
- Policies and Procedures: Policies and procedures should describe how ECT will be used in treatment; assure assessment of medical risk and current psychiatric evaluation; and identify treatment considerations for special populations generally served by the provider.
Setting
- Guidelines: Providers should identify the composition of the ECT treatment team and should include minimum staffing requirements. The use of the term team does not imply that staff members have to be identified by name. Instead the designation of team members should be identified by functional titles (e.g. ECT Nurse (RN)),since it is understood some flexibility in staffi…
Contraindications
- Anesthesia providers should be, at minimum, privileged to deliver general anesthesia and may include anesthesiologists or nurse anesthetists. If a nurse anesthetist is used to provide anesthesia, the treatment facility should establish policies and procedures assuring the timely on-site availability of an anesthesiologist as required under NYCRR Title 10 Part 405.13. Patients id…
Prevention
- Recovery Nurse - This person is a registered nurse whose responsibilities include monitoring of vital signs, pulse oximetry, ECG, and mental status, 2) administering oxygen and intravenous fluids, 3) provision of suctioning, and 4) management of postictal disorientation and agitation. ECT Nurse or Assistant - This person is usually an RN but may be an LPN or an assistant with E…