Electro-convulsive therapy

Electro-convulsive therapy (ECT) is a well-established, extremely effective and safe treatment in which seizures are electrically induced in anaesthetized patients for therapeutic effect.
Today, ECT is most often used in treatment resistant
• Depression
• Mania (often in bipolar disorder)
• Catatonia and schizophenia

It was first introduced in the 1930s

Today, an estimated one million people worldwide recieve ECT every year usually in a course of 6-12 treatments administered 2or3 times a week.

ECT not known to give rise to long term side effects.

It is safe in all three trimesters in pregnancy.

Relative contraindications include recent cerebro-vascular accident (stroke), heart disease and phaeochromocytoma.

Procedure:
• Intra-venous access
• Patient is ventilated
• Short acting intra-venous anaesthetics
• Intra-venous muscle relaxant
• Brain stimulation (unilateral /bilateral electrode placement) 

Mechanism of action: 
• Increase blood supply to brain
• Down grading of anxiety (beta) receptors
• Increase brain derived neurotropic factor (BDNF)
• Formation of new blood vessels in the brain

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