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ELECTROCONVULSIVE THERAPY ( ECT )

ELECTROCONVULSIVE THERAPY ( ECT ). doc.MUDr.Alexandra Žourková,CSc. Dept. of Psychiatry, Masaryk University, Brno. ELECTROCONVULSIVE THERAPY ( ECT ). THE INDUCTION OF A GRAND MAL SEIZURE BY MEANS OF AN ELECTRICAL PULSE THROUGH THE BRAIN.

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ELECTROCONVULSIVE THERAPY ( ECT )

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  1. ELECTROCONVULSIVE THERAPY ( ECT ) doc.MUDr.Alexandra Žourková,CSc. Dept. of Psychiatry, Masaryk University, Brno

  2. ELECTROCONVULSIVE THERAPY ( ECT ) • THE INDUCTION OF A GRAND MAL • SEIZURE BY MEANS OF AN ELECTRICAL • PULSE THROUGH THE BRAIN P R I N C I P L E O F E C T • THE PERSON IS UNDER ANESTHESIA

  3. ELECTROCONVULSIVE THERAPY ( ECT ) • UNKNOWN EXACTLY • ( NEUROTRANSMITTERS IN THE • BRAIN – GABA, ADRENALIN, • SEROTONIN, DOPAMINE, • ENDOGENOUS OPIATES …) MECHANISM OF ACTION

  4. ADMINISTRATION ( AWAKE AND NOT PREMEDICATED, COMPLICATIONS ) H I S T O R I C A L

  5. ADMINISTRATION • ATROPINE (REDUCE SECRETION) • GENERAL SHORT – ACTING ANESTHESIA • (REDUCE ANXIETY AND DISCOMFORT) N O W • DEPOLARIZING MUSCLE RELAXANT • (ELIMINATE COMPLICATIONS) • BILATERALLY ADMINISTRATION • UNILATERALLY ADMINISTRATION

  6. CLINICAL EVALUATION • MEDICAL HISTORY AND • PHYSICAL EXAMINATION • LABORATORY TEST • PRETREATMENT REGIMEN • INFORMAL CONSENT • ELECTRICAL STIMULUS • 70 – 110 V FOR 0,1 – 0,5 s / 200 – 1600mA • USUALLY NUMBER OF ECT • 6 – 10 THREE TIMES WEEKLY

  7. I N D I C A T I O N • MAJOR DEPRESSIVE EPIZODES • (WORKS MORE QUICKLY, IS SAFER, • IS PROBABLY MORE EFFECTIVE THAN TCAS) • ACUTE MANIA • SCHIZOFRENIA – AFFECTIVE AND • CATATONIC SYMPTOMS

  8. ABSOLUTE CONTRAINDICATION • A SPACE OCCUPYING CEREBRAL • LESION THAT CAUSES INCREASED • INTRACRANIAL PRESSURE

  9. S I D E E F F E C T S M O S T C O M M O N • TRANSITORY MEMORY LOSS • HEADACHE • MUSCLE ACHES

  10. S I D E E F F E C T S L E S S C O M M O N • INCREASE IN PERMEABILITY OF THE • BLOOD-BRAIN BARRIER • SYSTEMIC HYPERTENSION • APNEA • CARDIAC ARRHYTHMIAS

  11. References : • Waldinger R.J.: Psychiatry for medical students, Washington, DC : American Psychiatric Press, 1997 • Kaplan HI, Sadock BJ, Grebb JA.: Kaplan and Sadock´s synopsis of psychiatry, Baltimore: Williams and Wilkins, 1997

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