ect/rtms Flashcards
Which class of drugs raises seizure threshold?
Benzodiazepines, barbiturates, anticonvulsants
These drugs can be used in patients at risk of seizures.
Which class of drugs lowers seizure threshold?
Antipsychotics, antidepressants, lithium
These drugs may increase the risk of seizures in susceptible individuals.
How long should clozapine be suspended before ECT?
24 hours
This is to minimize potential complications during ECT.
How long should moclobemide be suspended before ECT?
24 hours
Similar to clozapine, this suspension helps reduce risks during ECT.
Why may lithium be best avoided before ECT?
It may increase cognitive side effects and neurotoxic effects
Lithium’s side effects can complicate the treatment process.
Who developed the first TMS device and in what year?
Anthony Barker in 1985
This development marked the beginning of TMS as a therapeutic tool.
What is TMS primarily used for?
Treatment of depression
It is one of the most studied somatic treatments for this condition.
What principle does TMS operate on?
Faraday’s principle of electromagnetic induction
This principle explains how magnetic pulses create electrical activity in neurons.
What type of TMS is used for migraine treatment?
Single pulse TMS
In contrast, repetitive TMS (rTMS) is used for depression.
What is the NNT for rTMS in treating depression after failed antidepressant trials?
4
This means that on average, 4 patients need to be treated with rTMS for one to benefit.
How long must rTMS be applied daily for treating depression?
30-40 minutes a day for at least 4 consecutive weeks
This duration is critical for achieving therapeutic effects.
Does TMS require anaesthesia?
No
TMS is usually an outpatient procedure with no recovery period.
What are common side effects of TMS?
Discomfort at the application site, transient headaches, facial muscular twitching
These side effects are generally mild and do not persist.
Can TMS induce a seizure?
Theoretically, but rarely in practice
No cases of seizure have been reported in 45 RCTs focusing on prefrontal application.
Is TMS effective for treating resistant auditory hallucinations?
Yes, if applied to the left temporoparietal cortex
However, its efficacy for this indication is smaller than for depression.
How does the short-term response rate of ECT compare to TMS?
ECT has significantly superior response rates, especially with psychotic features
This highlights ECT’s effectiveness in acute situations compared to TMS.
