Electro-convulsive therapy (ECT) is a well-established, extremely effective and safe treatment in which seizuresÂ are electrically induced in anaesthetized patients for therapeutic effect.
Today, ECT is most often used in treatment resistant
â€¢ Mania (often in bipolar disorder)
â€¢ 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.
â€¢ Intra-venous access
â€¢ Patient is ventilated
â€¢ Short acting intra-venous anaesthetics
â€¢ Intra-venous muscle relaxant
â€¢ Brain stimulation (unilateral /bilateral electrode placement)Â
Mechanism of action:Â
â€¢ Increase blood supply to brain
â€¢ Down grading of anxiety (beta) receptors
â€¢ Increase brain derived neurotropic factor (BDNF)
â€¢ Formation of new blood vessels in the brain