{"id":11766,"date":"2018-07-20T21:44:27","date_gmt":"2018-07-20T18:44:27","guid":{"rendered":"http:\/\/seragpsych.com\/wordpress\/?p=11766"},"modified":"2018-07-20T21:44:27","modified_gmt":"2018-07-20T18:44:27","slug":"electro-convulsive-therapy-facts-and-myths","status":"publish","type":"post","link":"https:\/\/seragpsych.com\/wordpress\/electro-convulsive-therapy-facts-and-myths\/","title":{"rendered":"Electro-Convulsive therapy : Facts and Myths"},"content":{"rendered":"

\nAs evidence supporting the use of
\nelectroconvulsive therapy (ECT)
\nto treat patients with depression
\nand other psychiatric illnesses continues
\nto grow, myths about this treatment
\npersist. In light of these myths, patients
\nmight be reluctant to receive ECT. As clinicians,
\nwe need to educate patients about
\nthe safety and effectiveness of this treatment.
\nHere are 10 of the most commonly
\nheld myths about ECT, and why each is a
\nmisconception.<\/h3>\n

<\/h3>\n

<\/h3>\n

<\/h3>\n

\n1. It is a barbaric treatment. ECT is conducted
\nin a controlled medical environment,
\neither during a hospitalization or as
\nan outpatient procedure, by a team, consisting
\nof a psychiatrist, anesthesiologist,
\nand nurse. Patients receive a short-acting
\nintravenous anesthetic to ensure that they
\nare unaware of the procedure, and a muscle
\nrelaxant to help prevent physical injury.
\nVital signs and brain waves are monitored
\nthroughout the procedure, which typically
\nlasts 15 to 20 minutes. Patients remain
\nrelaxed, are unaware that they are having a
\nseizure, and experience no pain. Following
\nECT, the patient is taken to a recovery area,
\nwhere he or she is closely monitored as the
\nmedications wear off.<\/h3>\n

<\/h3>\n

<\/h3>\n

\n2. It causes brain damage. Studies using
\nMRI to look at the brain before and after
\nECT have found no evidence that ECT
\ncauses negative changes in the brain\u2019s
\nstructural anatomy.1
\nTo the contrary, there
\nis evidence that there is neuroplasticity in
\nthe brain in response to ECT, and the neurotrophin
\nbrain-derived neurotrophic factor
\nalso may be increased.2,3<\/h3>\n

<\/h3>\n

<\/h3>\n

\n3. It causes permanent memory loss.
\nECT can result in both anterograde and
\nretrograde memory impairment; however,
\nanterograde amnesia typically lasts only
\ndays to weeks. Retrograde amnesia is much
\nless common, but when it occurs, it tends
\nto be a loss of memory of events that took
\nplace in the weeks leading up to and during
\ntreatment. Using an ultra-brief (as opposed
\nto standard brief,) pulse, as well as right
\nunilateral (as opposed to bilateral) electrode
\nplacement substantially reduces the risk of
\ncognitive and memory adverse effects.4<\/h3>\n

<\/h3>\n

<\/h3>\n

\n4. It is a treatment of last resort. Typically,
\nECT is used for patients who have not
\nresponded to other interventions. However,
\nECT can be used as a first-line treatment
\nfor patients if a rapid or higher likelihood
\nof response is necessary, such as when a
\na patient is suicidal, catatonic, or malnourished
\nas a result of severe depression.5
\n5. It only works for depression. Evidence
\nshows ECT is efficacious for several psychiatric
\nconditions, not just unipolar depressive
\ndisorder. It can effectively treat bipolar
\ndepression, mania, catatonia, and acute
\npsychosis associated with schizophrenia<\/p>\n

6. It is not safe. Death associated with
\nECT is extremely rare. A recent analysis
\nestimated that the rate of ECT-related
\nmortality is 2.1 deaths per 100,000 treatments.
\nIn comparison, the mortality rate
\nof general anesthesia used during surgery
\nhas been reported as 3.4 deaths per
\n100,000 procedures.8
\nEvidence also suggests
\nECT can be safely administered to
\npatients who are pregnant.9<\/h3>\n

<\/h3>\n

<\/h3>\n

\n7. It cannot be given to patients with epilepsy.
\nThere are no absolute contraindications
\nto using ECT for these patients. Most
\npatients with epilepsy can be successfully
\ntreated with ECT without requiring an
\nadjustment to the dose of their antiepileptic
\nmedications.10<\/h3>\n

<\/h3>\n

<\/h3>\n

\n8. It will change one\u2019s personality. ECT
\nhas not been found to cause any alterations
\nin personality. Patients who are treated
\nwith ECT may describe feeling more like
\nthemselves once their chronic symptoms of
\ndepression has improved. However, ECT
\nhas not been shown to effectively treat the
\nsymptoms or underlying illness of personality
\ndisorders and it may not be an effective
\ntreatment for depression associated with
\nborderline personality disorder.11<\/h3>\n

<\/h3>\n

<\/h3>\n

<\/h3>\n

\n9. Its success rate is low. ECT has the highest
\nresponse and remission rates of any
\na form of treatment used for depression.
\nAn estimated 70% to 90% of patients with
\ndepression who are treated with ECT show
\nimprovement.12<\/h3>\n

<\/h3>\n

<\/h3>\n

\n10. It is a permanent cure. ECT is not likely
\na permanent solution for severe depression.
\nThe likelihood of relapse in patients with
\nsevere depression who are helped by ECT
\ncan be reduced by receiving ongoing antidepressant
\ntreatment and some patients may
\nrequire continuation or maintenance ECT.13<\/h3>\n

<\/h3>\n

<\/h3>\n

<\/h3>\n

\nReferences
\n1. Scott AI, Turnbull LW. Do repeated courses of ECT cause
\nbrain damage detectable by MRI? Am J Psychiatry. 1990;
\n147(3):371-372.
\n2. Sartorius A, Demirakca T, B\u00f6hringer A, et al.
\nElectroconvulsive therapy increases temporal gray matter
\nvolume and cortical thickness. Eur Neuropsychopharmacol.
\n2016;26(3)506-517.
\n3. Bocchio-Chiavetto L, Zanardini R, Bortolomasi M et al.
\nElectroconvulsive therapy (ECT) increases serum brain-derived
\nneurotrophic factor (BDNF) in drug resistant
\ndepressed patients. Eur Neuropsychopharmacol. 2006;16(8):
\n620-624.
\n4. Sackeim HA, Prudic J, Nobler MS, et al. Effects of pulse
\nwidth and electrode placement on the efficacy and
\ncognitive effects of electroconvulsive therapy. Brain
\nStimul. 2008;1(2):71-83.
\n5. American Psychiatric Association. The practice of
\nelectroconvulsive therapy: recommendations for treatment,
\ntraining, and privileging: a task force report of the American
\nPsychiatric Association, 2nd edition. Washington, DC:
\nAmerican Psychiatric Association; 2001.
\n6. Fontenelle LF, Coutinho ES, Lins-Martins NM, et al.
\nElectroconvulsive therapy for obsessive-compulsive
\ndisorder: a systematic review. J Clin Psychiatry. 2015;76(7):
\n949-957.
\n7. Narang P, Glowacki A, Lippmann S. Electroconvulsive
\ntherapy intervention for Parkinson\u2019s disease. Innov Clin
\nNeurosci. 2015;12(9-10):25-28.
\n8. T\u00f8rring N, Sanghani SN, Petrides G, et al. The mortality
\nrate of electroconvulsive therapy: a systematic review and
\npooled analysis.\u00a0Acta Psychiatr Scand. 2017;135(5):388-397.
\n9. Sinha P, Goyal P, Andrade C. A meta-review of the safety
\nof electroconvulsive therapy in pregnancy. J ECT. 2017;33(2):
\n81-88.
\n10. Lunde ME, Lee EK, Rasmussen KG. Electroconvulsive
\ntherapy in patients with epilepsy. Epilepsy Behav. 2006;
\n9(2):355-359.
\n11. Feske U, Mulsant BH, Pilkonis PA, et al. Clinical outcome
\nof ECT in patients with major depression and comorbid
\nborderline personality disorder. Am J Psychiatry. 2004;
\n161(11):2073-2080.
\n12. Kellner CH, McClintock SM, McCall WV, et al; CORE\/
\nPRIDE Group. Brief pulse and ultrabrief pulse right
\nunilateral electroconvulsive therapy (ECT) for major
\ndepression: efficacy, effectiveness, and cognitive effects. J
\nClin Psychiatry. 2014;75(7):777.
\n13. Jelovac A, Kolshus E, McLoughlin DM. Relapse following
\nsuccessful electroconvulsive therapy for major depression:
\na meta-analysis. Neuropsychopharmacology. 2013;38(12):
\n2467-2474.
\nAn estimated
\n70% to 90% of
\npatients with
\ndepression who
\nare treated
\nwith ECT show
\nimprovement
\nDiscuss this article at
\nwww.facebook.com\/
\nMDedgePsychiatry
\ncontinued from page 9<\/h5>\n","protected":false},"excerpt":{"rendered":"

As evidence supporting the use of electroconvulsive therapy (ECT) to treat patients with depression and other psychiatric illnesses continues to grow, myths about this treatment persist. In light of these myths, patients might be reluctant to receive ECT. As clinicians, we need to educate patients about the safety and effectiveness of this treatment. Here are […]<\/p>\n","protected":false},"author":1,"featured_media":299,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[1609,1605,649,1603,1604,1607,1608,1606],"class_list":["post-11766","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-6","tag-arguementation","tag-convulsive","tag-depression","tag-ect","tag-electro","tag-facts","tag-myths","tag-therapy","entry"],"_links":{"self":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11766","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/comments?post=11766"}],"version-history":[{"count":1,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11766\/revisions"}],"predecessor-version":[{"id":11767,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11766\/revisions\/11767"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media\/299"}],"wp:attachment":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media?parent=11766"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/categories?post=11766"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/tags?post=11766"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}