Electroconvulsive Therapy Procedure

            How is Electroconvulsive Therapy (ECT) used to treat depression? To answer this question, we must first answer these other questions: What is electroconvulsive therapy? When depression is diagnosed, which patients are suitable for ECT and which for psychotherapy? If not all depressed patients will respond to ECT, how are we to identify those likely to benefit?.

             Invented by Cerletti and Bini, in 1938, ECT was the first form of therapy that reliably reduced severe depression (Abrams and Essman, 1982). Electroconvulsive therapy is a technique for treating psychiatric patients, in which seizures similar to those of epilepsy are induced by passing a current of electricity through the forehead (Encarta, 1995).

             Cerlitti started his experiments on dogs, applying electrodes to the mouth and anus. He did not want to try this experience on humans because half of the dogs being treated had died. Bini discovered that the reason for the dogs" deaths was that the current was traveling straight through to the heart. It was then that he tried putting the electrodes on the two temples. After this change, no more dogs died and his first human patient was in April of 1938 (Abrams and Essman, 1982).

             Side effects included temporary memory loss and intellectual impairment, with a slight risk of fractures and respiratory failure. In recent years such as side effects have been reduced by a modified treatment involving a much lower current and sometimes a reduced number of sessions (Groiler, 1993). Normally the current is administered three times weekly for two to six week"s (Fraser, 1982). .

             When ECT was first used, patients frequently suffered fractures while having convulsions, but muscle relaxant drugs are now routinely used to prevent such fractures (Encarta, 1995).

             For example, in the book Undercurrents, Martha Manning was given a shot of atropine which is used to dry secretions before many hospital procedures.

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