ECT Flashcards
when was ECT invented and by whom?
1938
Cerletti
length of a course of ECT
usually for between 6 and 12 treatments.
Remission rate in ECT?
When used as first-line Rx in severe depression
60-80%
what is the most effective short-term treatment for major depression
ECT
relapse rate in ECT
Very hight (80%) in absence of maintenance treatment
one example
of post-ECT maintenance pharmacological Rx?
combination of nortriptyline and lithium
the main limitation to the wider use of ECT
Cognitive effects:
- occasional acute confusion shortly after the treatment
- retrograde amnesia
comparison in effectiveness
bi- or uni-lateral ECT?
Bilateral ECT is more effective (and works faster) than unilateral ECT but may cause more cognitive impairment.
NICE recommend ECT
only to achieve rapid and short-term improvement of severe symptoms
- after an adequate trial of other treatment options has proven ineffective
- when the condition is considered to be potentially life-threatening
conditions
Recommended by NICE to use ECT (DEPRESSION)
- Severe Depression
- Moderate Depression
- Catatonia
- Severe Manic episode (or prolonged)
RCPsych position on ECT
- First line
- 2nd line
- Indicated
According to RCPscyh
ECT used in 1st line if
- rapid definitive response needed
- Suicidal
- Severe Psychomotor retardation
- Rx Resistence with + outcome after previous ECT
- Pregnant with severe depression
- Prefers
- Malignant catatonia
According to RCPscyh
ECT used in 2nd line if
- Rx resistant
- severe side effect of Rx
- Deteriorated pchiatric comorbidities
- Life threatening or persistant mania
according to RCPsych
ECT indicated in
- Bipolar Depression
- Post-natal psychosis
- Rx resistant schizophrenia
- catatonia
- Frequent relapses of depression
