What is the maximum number of ECT treatments?
What is the maximum number of ECT treatments? 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.
What is the success rate of ECT therapy?
What is the Success Rate of Electroconvulsive Therapy? ECT is an effective medical treatment option, helping as many as 80-85 percent of patients who receive it. Most patients remain well for many months afterwards. The tendency to relapse after a favorable treatment outcome can often be countered by medication after a series of treatments.
How many ECT treatments is too many?
How many ECT treatments is too many? It is important to realize that a ‘course ‘ of ECT entails a series of treatments given 2-3 times per week until maximal improvement has occurred. Most patients require 6 to 12 total treatments.
What is the success rate of ECT?
What is the Success Rate of Electroconvulsive Therapy? ECT is an effective medical treatment option, helping as many as 80-85 percent of patients who receive it.
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Is ECT used in the US?
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.
What is the average number of ECT treatments?
People undergoing ECT need multiple treatments. The number needed to successfully treat severe depression can range from 4 to 20, but most people need a total of 6 to 12 treatments. The treatments are usually given three times a week — Monday, Wednesday, and Friday.
What is the success rate of ECT therapy?
Typically, ECT (whether inpatient or outpatient) is given two to three times a week for a total of six to twelve sessions. Some patients may need more or fewer treatments. These sessions improve depression in 70 to 90 percent of patients, a response rate much higher than that of antidepressant drugs.
What is the failure rate of ECT?
Not only does it work better than medications (according to Weeks, medications have a success rate of 50–60 percent of patients getting better, while ECT succeeds at a rate of 70–90 percent), it works faster. Medications typically take up to eight weeks to show improvement.
How many people receive ECT per year?
Today, ECT is administered to an estimated 100,000 people a year, primarily in general hospital psychiatric units and in psychiatric hospitals. It is generally used in treating patients with severe depression, acute mania, and certain schizophrenic syndromes.
Why is ECT so controversial?
Reasons for Controversy Three reasons are given for the aversion: 1) ECT is considered old-fashioned and politically incorrect; 2) it is forced on the patient; and 3) the memory disturbances are so severe and persistent that no rational human being would undergo this procedure, no matter how well-intended.
Is ECT worth the risk?
Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions. Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression.
Does ECT damage the brain?
The review of literature and present evidence suggests that ECT has a demonstrable impact on the structure and function of the brain. However, there is a lack of evidence at present to suggest that ECT causes brain damage.
What are some of the drawbacks to ECT?
Cons of ECT: Confusion post-treatment. Typically not well tolerated in the elderly population. Memory loss (retrograde amnesia) which usually improves within a couple months of the procedure. Physical side effects related to tension (nausea, headache, jaw aches, and muscle aches.
Does ECT worsen anxiety?
The concern of some psychiatrists is that while ECT may help with depressive symptoms, it could worsen anxiety symptoms, including obsessional thoughts or panic attacks.
How long does ECT remission last?
We know that depressed patients often begin to respond after the first treatment and progress to wellness with 6 to 12 treatments. There is considerable variability in the trajectories, but most commonly there is progressive symptomatic improvement within the first week and complete remission within 3 to 4 weeks.
Can you feel worse after ECT?
ECT can't prevent future depression, or fix any ongoing stresses or problems that are contributing to how you're feeling. Some people have very bad experiences of ECT, for example because they feel worse after treatment or are given it without consent. You might not want to risk the possibility of getting side effects.
When was ECT first used?
ECT was first developed by Italian psychiatrist Ugo Cerletti in 1938 when he saw that electric shock used on pigs at a Rome slaughterhouse induced epileptic attacks and then considered its use on humans. It was first called “electroshock treatment.” [4]
How much electricity does ECT send?
ECT sends up to 460 volts of electricity [2] through the brain in order to induce a grand mal seizure, a type of seizure that involves a loss of consciousness and violent muscle contractions, masked by an anesthetic.
Why did the FDA withdraw the ECT rule?
Rather, nearly 10 years later, the FDA issued a Notice on November 26, 2004, announcing the withdrawal of certain rules, which included the September 1990 proposed ECT rule, claiming this was because FDA was “to reduce its regulatory backlog and focus its resources on current public health issues.”.
How many people are given electroshock?
Factually, ECT is one of the most brutal “treatments” ever inflicted upon individuals under the guise of mental health care. Yet approximately one million people worldwide, including an estimated 100,000 Americans, are given electroshock each year, including the elderly, pregnant women and children. [1]
When was the ECT procedure invented?
1938: The procedure was born out of an Italian slaughterhouse in 1938 when psychiatrist Ugo Cerletti saw how pigs were easier to slaughter after being electroshocked and decided to try it on humans. He adapted electric shock techniques used to stun animals to create ECT. [29] His first human patient begged Cerletti, “Non una seconda! Mortifere!” (“Not another one! It will kill me!”) [30] It did not matter to psychiatrists that Cerletti had offered no explanation as to how ECT worked. [31] He called it “electric shock treatment.”
Why don't patients break bones with ECT?
[i] The only reason patients don’t regularly break bones with modern ECT is due to the administration of a muscle relaxant prior to the procedure.
What is electrical shock torture?
Torture Called Treatment: Electrical shock has been used for torturing political dissidents, such as is in China, or inflicted upon prisoners of war (such as Abu Ghraib in Iraq), which the United Nations (UN) classified as torture.
What age group is most likely to receive ECT?
People are more likely to receive ECT between the ages of 50-69 more than any other age group. This accounts for nearly half of all treatments. 6. ECT is rarely a first-time treatment option in youth – only 35 kids between 16-19 years of age received a treatment in the last year. 7.
How high is the fatality rate for ECT?
1. Some studies have found that the fatality rate in ECT treatments is as high as 2.9 per 10,000 patients. Others have found fatality rates to be as low as 4.5 per 100,000 patients. 2. Up to 40% of ECT patients in New York receive treatments based on court orders.
What comes to mind when you think about Electroconvulsive Therapy?
What comes to mind when you think about Electroconvulsive Therapy [ECT]? For many, visions of the old-fashioned shock therapies that required patients to wear a helmet covered in electrodes and endure large amounts of voltage come to mind. It’s often thought of as something from the Stone Age of medicine and is barbaric at best. What you might not know is that ECT is not only still in use today, but it is often prescribed more often than you might think.
How does ECT work?
ECT works by delivering a shock to the mind that creates a seizure. In many ways, it seems to reboot the entire brain so that it can lift the veil of depression. It might even be able to reconnect nerves or neuroconnections that have stopped functioning properly for some reason.
How long does memory last after ECT?
Memory complications can easily last for up to 3 years past the procedure date.
How long does memory complications last after ECT?
Memory complications can easily last for up to 3 years past the procedure date. There are also other issues, such as poor circulatory health, that could actually end up causing someone to die during the procedure that is being forced upon them by the court system.
How many people are diagnosed with manic depression after ECT?
The number of people diagnosed with manic depression after an ECT treatment: 1 in 2. 14. More than 35% of people who receive an ECT treatment are later diagnosed with schizophrenia. 15. According to the Royal College of Psychiatrists, over 80% of depressed patients who receive ECT respond well to it.
How many people are treated with ECT?
Today, ECT is administered to an estimated 100,000 people a year, primarily in general hospital psychiatric units and in psychiatric hospitals. It is generally used in treating patients with severe depression, acute mania, and certain schizophrenic syndromes.
When is ECT treatment given?
ECT treatment is generally administered in the morning, before breakfast. Prior to the actual treatment, the patient is given general anesthesia and a muscle relaxant. Electrodes are then attached to the patients scalp and an electric current is applied which causes a brief convulsion.
What is ECT?
Electroconvulsive therapy (ECT) is a procedure in which a brief application of electric stimulus is used to produce a generalized seizure. It is not known how or why ECT works or what the electrically stimulated seizure does to the brain. In the U.S. during the 1940’s and 50’s, the treatment was administered mostly to people with severe mental illnesses. During the last few decades, researchers have been attempting to identify the effectiveness of ECT, to learn how and why it works, to understand its risks and adverse side effects, and to determine the best treatment technique. Today, ECT is administered to an estimated 100,000 people a year, primarily in general hospital psychiatric units and in psychiatric hospitals. It is generally used in treating patients with severe depression, acute mania, and certain schizophrenic syndromes. ECT is also used with some suicidal patients, who cannot wait for antidepressant medication to take effect.
Why is ECT so controversial?
Much of the controversy surrounding ECT revolves around its effectiveness vs. the side effects, the objectivity of ECT experts, and the recent increase in ECT as a quick and easy solution, instead of long-term psychotherapy or hospitalization.
Is ECT effective after a relapse?
It is also unclear whether or not ECT is effective. In some cases, the numbers are extremely favorable, citing 80 percent improvement in severely depressed patients, after ECT. However, other studies indicate that the relapse is high, even for patients who take medication after ECT.
Who administers ECT?
The procedure should be administered by trained health professionals with experience in ECT administration as well as a specifically trained and certified anesthesiologist to administer the anesthesia. The seizure initiated by the electrical stimulus varies from person to person and should be monitored carefully by the administration team. Monitoring should be done by an EEG or “cuff” technique.
Is ECT a history of abuse?
The nature of ECT, its history of abuse, unfavorable medical and media reports, and testimony from former patients all contribute to the debate surrounding its use. Research should continue, and techniques should be refined to maximize the efficacy and minimize the risks and side effects resulting from ECT.
How many people receive ECT?
Worldwide, it has been estimated that about one million patients receive ECT annually (Prudic et al. 2001). ECT appears to have become a widely available treatment for mental disorders on all continents (Swartz 2009), in USA/Canada and Latin America (Magid and Rohland 2009; Rosa and Rosa 2009), Western Europe (Benbow and Bolwig 2009; Sienaert and van den Broek 2009) and Russia (Nelson and Giagou 2009), Africa and Asia (Chang 2009). Despite international guidelines (American Psychiatric Association 2001; Royal College of Psychiatrists 2005; Enns et al. 2010), large variations in clinical practice between countries and regions have been reported (Hermann et al. 1995; Glen and Scott 2000; Bertolin-Guillen et al. 2006; Gazdag et al. 2009a). Reports on ECT utilization also largely vary. There have been some international studies. A study by Van Waarde et al. (van Waarde et al. 2009) included data from nine other countries and another by Gazdag et al. (Gazdag et al. 2009a) presented an overview of 13 surveys undertaken on the use of ECT in the past 10 years. In the United States, the nationwide number of persons ECT treated per 10,000 resident population per year, was estimated to be 4.9 in 1995 (Hermann et al. 1995). On the whole, there seems to be a paucity of updated ECT utilization surveys, reviews, and data. There is, therefore, an imminent need for a systematic international review concerning contemporary use of ECT. Against this background, the main objective of this article is to give a systematic contemporary overview (from 1990) of the extent to which ECT is used worldwide.
What is ECT used for?
ECT was originally used in the treatment of schizophrenia. ECTs effectiveness for patients with depression was established in 1941 (Hemphill and Walter 1941). The use of ECT declined in the 1970s and 1980s after the introduction of pharmacotherapy for severe mental disorders (McCall 2001). The main indication for ECT also transformed from first-line to last-resort treatment for medication-resistant and very severe life-threatening clinical conditions (McCall 2001; Eranti and McLoughlin 2003). However, in 2001, guidelines developed by the American Psychiatric Association (APA) advised that ECT should not only be used as a last resort (American Psychiatric Association 2001). Situations of increased risk that need special attention are mentioned by international guidelines, such as patients with disorders of the central nervous system, cardiovascular and respiratory system (American Psychiatric Association 2001; Royal College of Psychiatrists 2005; Enns et al. 2010). As a result of cognitive side effects (memory impairment) association with sine-wave current (The UK ECT Review Group 2003), it is now advised that brief-pulse wave be the standard treatment (American Psychiatric Association 2001; Royal College of Psychiatrists 2005; Enns et al. 2010). The use of sine-wave constant voltage and constant energy devices is currently not considered justified (APA guidelines) (American Psychiatric Association 2001).
What is the purpose of electroconvulsive therapy?
Convulsive interventions have been used to treat mental disorders since the 16th century and even today in the form of electroconvulsive therapy (ECT). Ugo Cerletti and Luigi Bini demonstrated ECT in Rome for the first time in 1938 (Cerletti and Bini 1938). The ECT intervention per se, that is, the application of electrical current to the scalp in order to provoke a generalized epileptic seizure, for the purpose of alleviating psychotic and depressive symptoms, is still much the same today as it was in the beginning. Modifications of Cerletti and Bini's original bitemporal placement of electrodes to the scalp, administering 120 V sine-wave electrical current to the head (Cerletti and Bini 1938), include the development of newer brief-pulse electrical current wave devices and unilateral (UL) placement of electrodes.
Why did ECT spread?
ECT spread rapidly from Europe to other continents and to the United States, due to the Second World War's displacement of psychiatrists (Shorter 2009). In the beginning, ECT was administered without anesthesia (termed unmodified ECT) and later, under anesthesia together with muscle relaxant succinylcholine medication (termed modified ECT), in order to reduce side effects from the convulsions, such as bone fractures, teeth, tendon, and muscular damage. In the last decade, modified ECT has been recommended as the standard routine according to internationally established guidelines (American Psychiatric Association 2001; Royal College of Psychiatrists 2005; Enns et al. 2010).
Who published the 2012 The Authors?
Copyright© 2012 The Authors. Published by Wiley Periodicals, Inc.
Is ECT unmodified in Europe?
In Europe, all parameter report indicated modified ECT, except for Russia (in contrast to Hungary [Gazdag et al. 2004a], with obligatory anesthesia) where >80% was unmodified (Nelson 2005). In the Chuvash Republic, ECT was modified, but 40% without use of muscle relaxants (and administered mainly to women with schizophrenia) (Golenkov et al. 2010). In Spain, 0.6% received unmodified ECT, and 2.3% without muscle relaxants (Bertolin-Guillen et al. 2006).
How long does it take for ECT to work?
ECT works much faster than medications. On average, ECT takes two tothree weeks to take effect. By contrast, medications usually take six to eightweeks for improvements to become apparent.
What is consent before ECT?
Before the first ECT treatment, a patient will have a thorough psychiatricevaluation as well as a complete physical exam. The patient must also signinformed consent documents authorizing the use of ECT. “Consent” meansthat you understand the procedure as well as its risks and benefits. (See pages33–35 to review the informed consent forms we use at Johns Hopkins.)
How many times a week is ECT given?
Typically, ECT (whether inpatient or outpatient) is given two to three times a week for a total of six to twelve sessions. Some patients may need more or fewer treatments.
How can families help patients who will be receiving ECT?
Families can help by providing a gentle reminder of the day and date and that feeling confused is to be expected.
When is ECT used?
This delay can be dangerous for patients whose depression is accompanied by delusions (false beliefs) or intense suicidal thoughts. ECT can work much more quickly than antidepressants and is useful when patients are at immediate risk for self-injury or suicide.
What happens during an ECT procedure?
Before ECT, patients are asked not to eat or drink from midnight the night before treatment.
How long is an ECT procedure?
A single ECT session usually lasts one hour. This includes the time the patient will be in the treatment room (approximately 15-20 minutes) and the time spent in the recovery room (approximately 20-30 minutes).
What are the side-effects of ECT?
The immediate side effects of the procedure which may last for about an hour include:
How does ECT work?
Why does ECT work? 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, which are known to be involved in conditions like ...
