ECT

Question 1

ECT- electroconvulsive therapy
(views)
(how done)

Answer 1

1- single most effective treatment in psychiatry.
2- mostly last resort but valuable for unresponsive melancholia & psychiatric depress.
3- dmging treatment should be banned.

Direct electrical current through brain- electrodes on skull & produce “Grandmal Epileptic Seizure”
–other means been tried (inject, inhaling but not as effective). -now regarded as safe.

Question 2

50+ years modified ECT

how & side effects

Answer 2

use general anesthetic, muscle relaxant, ventilation.
Admin- 2-3x week for 2-6 weeks up to 12 weeks.
–may see immediate effect.
–ECT comparable to alternative treatments in terms of safety/effec– e.g. antipsychotics & brain surgery.

side effects- immediate retrospective memory loss, few secs before ECT applied.

• groggy, dozy for few hours after awakening.
• “gap” memory for period of treatment. No lasting memory probs.

Question 3

Indication of ECT effectiveness

Answer 3

1- Melancholia & PD
2- Mania
3- Acute Sz eps
4- Parkinson's disease + Lewy body dimentia
5- Catatonia

Question 4

Ketamine

Answer 4

invented 1970 anesthetic- in high dose.

• analgesic, stimulant- dissociative/mythical/dreamy/mildy psychotic state on awakening.
• treatment for melancholia/psychotic depress.
• 40 mins intravenous infusion 2/3x a week.
• very rapid- breakthrough.

Ket effect discovered in 2000- classified by 1 of chemical effects- NMDA recep blocker.

Ket for severe depress (breakthrough) downplayed & new gen NMDA recep blockers- dev for mild-mod depress- outpatient use- intranasal spray- mucus membrane.