when ect treatment doesn't work

What to do if ECT fails?

• The anesthesiologist delivers two drugs through the IV line: anesthesia to put you asleep and a muscle relaxant to minimize muscle contractions during the procedure itself.
• A blood pressure cuff inflates around your ankle to prevent the muscle relaxant from entering the foot. ...
• An oxygen mask is placed over your face. ...

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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.

When ECT does not work?

Does ECT Work? ECT is an extremely effective treatment. The great majority of patients treated with ECT have significant improvement. ECT even helps most patients who have not been helped by medications and talk therapy. Scientific evidence shows that ECT produces substantial improvement in about 80% of people with severe depression.

How many ECT treatments are needed?

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.

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What happens if ECT doesn't work?

If nothing else has helped, including ECT, and you are still severely depressed, you may be offered neurosurgery for mental disorder (NMD), deep brain stimulation (DBS) or vagus nerve stimulation (VNS).

How many ECT treatments does it take to work?

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 for ECT?

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.

Can ECT stop working?

ECT can often work quickly, but 50% or more of the people who receive this treatment will relapse within several months if there is no subsequent treatment (for example, medicines) to prevent relapse.

Does ECT work for everyone?

ECT does not work for everyone. It will not cure your underlying illness. Many patients need continuing treatment after doing ECT. This could include maintenance ECT treatments, talk therapy, medicine, or a combination of the three.

How many sessions of ECT can you have?

ECT is usually given twice a week for 3-6 weeks, meaning you might have around 6-12 sessions. You should be assessed after each treatment to see if another one is necessary, or isn't advisable. ECT tends to provide short-term improvements, so it can be helpful to try other types of treatments after having it.

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.

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.

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 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.

Can ECT change your personality?

ECT does not change a person's personality, nor is it designed to treat those with just primary “personality disorders.” ECT can cause transient short-term memory — or new learning — impairment during a course of ECT, which fully reverses usually within one to four weeks after an acute course is stopped.

What medications should be stopped 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.

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.

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 ...

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, ...

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.

Can anesthesia cause heart problems?

These generally can be treated with medications. Medical complications. As with any type of medical procedure, especially one that involves anesthesia, there are risks of medical complications. During ECT, heart rate and blood pressure increase, and in rare cases, that can lead to serious heart problems.

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.

Life After ECT Failure

If ECT has about a 80% success rate in depression then that, naturally, means that about 20% of people are not helped by it. What do those people do? Do they all just up and die?

ECT Failed -- What Do I Do?

You can find Natasha Tracy on Facebook or Google+ or @Natasha_Tracy on Twitter or at Bipolar Burble, her blog.

How many ECT treatments is too many?

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.

When should ECT not be used?

a past history of moderate or severe depression or. initial presentation of subthreshold depressive symptoms that have been present for a long period (typically at least 2 years) or. subthreshold depressive symptoms or mild depression that persist (s) after other interventions.

How long do the effects of ECT 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.

What medications should be stopped before ECT?

Benzodiazepines, Depakote, Lamictal, Neurontin, Trileptal – Do not take the night time dose or morning dose before your treatment. Lithium – Do not take for 24 hours before each treatment. Glucophage/Metformin – Do not take for 12 hours before each treatment.

Can ECT make you worse?

ECT may have a role in people who have comorbid depression and 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.

Who is ECT Not recommended for?

Not everyone is a candidate for treatment even if they believe ECT could help them. For example, children under age eleven cannot undergo ECT for mental health disorders. People with heart conditions and people who cannot handle short-acting sedatives or muscle relaxers should not undergo ECT treatments.

Can ECT change your personality?

ECT does not change a person’s personality, nor is it designed to treat those with just primary “ personality disorders.” ECT can cause transient short-term memory — or new learning — impairment during a course of ECT, which fully reverses usually within one to four weeks after an acute course is stopped.

What is true about every patient who seeks treatment with ECT?

Ultimately, Seiner said, two things are true generally about every patient who seeks treatment with ECT. “One is that they’re really struggling, and two, they’re terrified about what we do. It’s important to get them better, but our job is to walk them through it, to be there with them. This is what we’re committed to.

How effective is ECT?

What is clear is that for severe illness, such as psychotic depression or catatonia, where patients can lose 40-50 pounds and can be at some risk of death, ECT has been shown to be 80-95% effective.

How long after ECT do you get better?

The research indicates that if you wait two months after ECT, or six months, after the ‘dust’ of the ECT has settled, most people do much better on neuropsychological testing than they did before ECT. That’s because when people aren’t depressed, they think better and test better.”.

Can seizures reset the brain?

Scientists know seizures can reset brain function. And because brain activity involves electrical signals passing through neurons, ECT “is like when you reboot your computer when something has gone awry,” said Paula Bolton, MS, APRN-BC, program director of McLean’s Psychiatric Neurotherapeutics Program.

Is ECT good for depression?

Using ECT to Treat Depression. Effective treatments for depression include counseling, psychotherapy, and prescription medications. However, for an estimated 100,000 people a year in the United States, like Neville, these options fall short. And for them, ECT is safe, reliable, and effective. The treatment has evolved since ...

How long does it take for ECT to go away?

These cognitive deficits have been shown to go away between 1-6 months after treatment ends.

How effective is ECT for depression?

ECT is the most effective known treatment for depression with remission rates of 50-80% (give or take depending on the study), even for treatment-resistant depression.

Is ECT evil?

Are There Actually Pros to ECT? Some people will tell you that ECT is evil and there are no benefits worth the side effects. Some people will tell you that ECT is inhumane and should be banned. Some people say that anyone who gets ECT is submitting to some form of assault. All of this is poppycock.

Can bilateral ECT cause memory loss?

The more ECT you do and the more bilateral ECT you do, the greater your risk of side effects like memory loss . The positive effects of ECT may be short-lived leaving you with the choice as to whether to have ECT again. (Doctors try to prevent this by selecting medication for you when you get better that will keep you better.)

Is unilateral ECT a pro or con?

Yes, it’s that successful and painless for some. One other factor that is an ECT pro and con is that typically, unilateral ECT is tried first (there are fewer side effects) but if that isn’t effective, a stronger form of ECT (bilateral) can be tried. It’s a pro because it’s an option but it’s a con because of the increased side effects.

Is ECT covered by insurance?

ECT seems unbelievably effective in treating catatonia with a success rate of over 90% in those, severe cases. ECT is typically covered by insurance ( I wish that weren’t a factor for people but, let’s face it, it is).

Does ECT cause headaches?

ECT can produce physical pain during the treatment. This is muscular and has to do with the invoked seizure, the anaesthesia or both. Headaches are common. This pain is typically easily treated with over the counter medications or, in some cases, prescribed medication like acetaminophen with codeine.

Overview

Why It's Done

Risks

How You Prepare

• I became convinced that I was absolutely not awake, and that everything I was experiencing was a disturbing dream. Nothing I did had real-life consequences in my mind, so I stopped being concerned about how my actions and words might affect others. I am sure that to those around …

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What You Can Expect

Results