ECT Flashcards

1
Q

What is ECT?

A

The passage of a small electrical current through the brain with a view to inducing a generalised fit which is therapeutic

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2
Q

What are the indications for ECT?

A

Depression- severe, suicidal, life threatening or moderate/ severe resistant
Uncontrolled mania
Catatonia

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3
Q

Is bilateral or unilateral ECT more effective?

A

Bilateral

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4
Q

Are cognitive side effects more severe with bilateral or unilateral ECT?

A

Bilateral

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5
Q

What is the dose for bilateral ECT?

A

ST*1.5

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6
Q

What is the dose for unilateral ECT?

A

ST*6

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7
Q

What physiological changes are seen during ECT?

A

First pulse slows then rises sharply : 130-190/min
Falls to resting rate around end of seizure then less marked tachycardia for a few minutes
BP rises up to 200mmHg systolic
Cerebral blood flow increases by up to 200%

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8
Q

What are the possible side effects of ECT?

A
Nausea and vomiting 
Headache
Muscle aches 
Cognitive effects - immediate confusion, retrograde and anterograde amnesia 
Prolonged seizures
Anaesthesia risks
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9
Q

What are some relative contraindications for ECT?

A
Raised intracranial pressure 
Aneurysms 
MI in last 3 months 
Risk of embolism - recent stroke, DVT 
Uncontrolled BP/HR
Acute glaucoma
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10
Q

Is ECT contraindicated in pregnancy?

A

No

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11
Q

What monitoring is done during ECT?

A

EEG
O2 saturations
BP
HR

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12
Q

Should antidepressants be stopped when commencing ECT?

A

No but safely reduce them to minimum dose

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