ECT

Question 1

What is ECT?

Answer 1

Electroconvulsive therapy

Passage of a small amount of electrical current through the brain with the aim of inducing a modified epileptic seizure which is therapeutic

Question 2

How is ECT conducted?

Answer 2

Under GA (etomidate/Propofol)

With muscle relaxant (suxamethonium)

Question 3

What are the indications for ECT?

Answer 3

Prolonged/severe mania
Catatonia
Treatment resistant depression 
Suicide risk 
Life threatening depression 
Puerperal psychosis

Question 4

What are the contraindications for ECT?

Answer 4

Anaesthetic risk 
MI within 3 months
Aortic/cerebral aneurysm 
Raised ICP 
Stroke within 1 month

Question 5

What are the types of ECT?

Answer 5

Unilateral

Bilateral

Question 6

What are the features of unilateral ECT?

Answer 6

Both electrodes on same side
Seizure threshold x3
Fewer cognitive side effects

Question 7

What are the features of bilateral ECT?

Answer 7

Electrodes bitemporal/bifrontal
Seizure threshold x1.5
More effective
More cognitive side effects

Question 8

What are the physiological effects of ECT?

Answer 8

EEG changes
Raised pulse
Raised BP
Raised cerebral blood flow

Question 9

What is seizure threshold?

Answer 9

Minimum electrical stimulus required to induce a seizure

Question 10

Which drugs increase the seizure threshold?

Answer 10

Anaesthetic drugs
Anticonvulsants
Benzodiazepines
Barbiturates

Question 11

Which drugs lower the seizure threshold?

Answer 11

Antipsychotics
Antidepressants
Lithium

Question 12

What are the side effects of ECT?

Answer 12

Anaesthesia side effects

Retrograde/anterograde amnesia
Muscle aches
Confusion
Dental/oral trauma