ECT Flashcards
1
Q
Indications
A
MDD - Severe, functional impairment, psychosis, or catatonia - Pregnant Bipolar - Severe or tx resistant - Pregnant Schizophrenia and related disorders - Acute only - Severe or treatment resistant - Use with antipsychotics
2
Q
Contraindications
A
Absolute
- None
Relative
- Brain pathology
3
Q
Empirical titration
A
Progressively higher doses
Most precises
4
Q
Formula-based titration
A
Calcualted
- Age, gender, and electrode placement
5
Q
Fixed dose
A
Fixed
6
Q
Frequency of txs
A
3 times per week
- most common
- memory impairment
2 times per week
- Less memory impariment
- Potentially the same benefit
7
Q
Number of treatments
A
Typical
- 6 to 12
Total number
- Depends on degree and rate of clinical improvement
- Depends on severity of cognitive adverse effects
8
Q
Leading cause of mortality
A
Arrhythmias and pulmonary complications
9
Q
Cognitive & Other adverse effects
A
Cognitive
- Disorientation
- Attention
- Praxis
- Memory
Other
- Asystole
- Prolonged seizures
- Prolonged apnea
- Headache
- Muscle soreness
10
Q
Continuation ECT
A
Prevent relapse
- Hx of ECT-reponsive illness
- Patient preference
- Resistance or intolerance to meds
- Inability to adhere to treatment plan
11
Q
Maintenance ECT
A
Prevent recurrence
- Same as continuation
12
Q
MOA
A
Induces bilateral generalized seizures
- Increases GABA, which decreases seizure threshold
- Effects numerous other neurotransmitters in the CNS
