ECT indications

Question 1

What is ECT considered for in depressive illness?

Answer 1

First line treatment for:
* Emergency treatment of depression where a rapid definitive response is needed
* Treatment resistant depression in patients who have responded to ECT in a previous episode

Question 2

When is ECT the treatment of choice for depressive illness?

Answer 2

When associated with:
* Life threatening situation due to refusal of food and fluids
* High suicide risk
* Stupor
* Marked psychomotor retardation
* Depressive delusions and hallucinations (Psychotic depression)
* Pregnant patients concerned about teratogenic effects of antidepressants and antipsychotics

Question 3

What is the role of ECT in treatment resistant depressive illness?

Answer 3

Considered as second or third line treatment when not responding to antidepressant drugs

Question 4

What conditions may ECT be considered for in the treatment of mania?

Answer 4

When associated with:
* Life threatening physical exhaustion
* Prolonged and severe mania with lack of response to all other appropriate drug treatments

Question 5

What is the fourth line option for treatment resistant schizophrenia?

Answer 5

ECT may be considered after treatment with 2 antipsychotic drugs and clozapine has proved ineffective

Question 6

When is ECT indicated in patients with catatonia?

Answer 6

When treatment with a benzodiazepine (usually lorazepam) has proved ineffective

Question 7

What is the role of ECT in Parkinson’s disease?

Answer 7

As an adjunctive treatment for motor, psychotic and affective symptoms in severe disability despite medical treatment

Question 8

What is one condition where ECT may be indicated for treatment?

Answer 8

Neuroleptic malignant syndrome

Question 9

What is another condition where ECT may be indicated?

Answer 9

Intractable seizure disorders (acts to raise seizure threshold)