How many ect treatments

All authors contributed to the data analysis, drafting, and revising of the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. National Center for Biotechnology Information , U. Journal List Neuropsychiatr Dis Treat v. Neuropsychiatr Dis Treat. Published online Mar 4. Author information Article notes Copyright and License information Disclaimer.

Received Dec 28; Accepted Feb This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4. This article has been cited by other articles in PMC. Abstract Objective To study predictors of the number of electroconvulsive therapy ECT sessions required for symptom remission in psychiatric patients.

Patients and Methods We conducted chart reviews for 95 patients whose condition remitted following inpatient ECT. Conclusion The number of ECT sessions varied by age and diagnosis. Keywords: ECT, treatment, Thai patients, major depressive disorder, elderly.

Introduction Electroconvulsive therapy ECT has been used to treat psychiatric conditions since the s. Open in a separate window. Abbreviation: SD, standard deviation. Figure 1. Discussion As a result of our study, we found that the mean of the number of ECT sessions was Conclusion We found that the number of ECT sessions varied according to age and diagnosis.

Acknowledgments Special thanks to staff at the Electroconvulsive Therapy Clinic, Ramathibodi Hospital, for supporting the data collection process. Author Contributions All authors contributed to the data analysis, drafting, and revising of the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. Disclosure The authors report no conflicts of interest. References 1. Clinical Manual of Electroconvulsive Therapy.

Arlington: American Psychiatric Publishing; American Psychiatric Association. American Psychiatric Association; Rapid response to electroconvulsive therapy: a case report and literature review. J ECT. Contemporary use and practice of electroconvulsive therapy worldwide. Some people have trouble remembering events that occurred in the weeks before the treatment or earlier. In most cases, memory problems improve within a couple of months.

Some patients may experience longer lasting problems, including permanent gaps in memory. The risks of general anesthesia, which is needed for ECT, are similar to the risks when anesthesia is used for other procedures such as minor surgeries. The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours.

These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders. For some patients, the risks of ECT may be less than those of ongoing treatment with medications.

ECT can work more quickly than medications. It can be especially useful if a patient is suicidal, is not responding to medications or cannot tolerate the side effects of medication. Transcranial Magnetic Stimulation TMS is used to treat depression that has not responded to other therapies. It involves the use of rapidly alternating magnetic fields to stimulate specific areas of the brain.

TMS typically only has mild side effects including headaches, muscle twitches and pain at the stimulation site. The effect is to cause theoretically more memory problems. Unilateral electrode placement allows both electrodes to be kept on one-side of the brain the non-dominant side , which avoids having electricity pass directly through the language and memory centers mentioned above.

However it requires that the seizure which will now start on one side of the brain only to generalize or move across to the other side of the brain.

A type of recurrent mood disorder characterized typically by both manic episodes and depression See Depression. Some individuals may have primarily manic episodes; others may have mostly depressions with rare manic periods, while others may have mixed symptoms of both mania and depression.

Episodes can be infrequent or rapid-cycling i. Lithium has been the traditional medication used to treat this disorder though many other agents are now available as well. Note that ECT works very well for both mania and depression. A treatment modality using small amounts of electricity to generate a grand-mal seizure in a patient, in an attempt to treat various psychiatric disorders, especially depression. Symptoms need to be present for at least 2 weeks and be severe enough to cause some functional impairment.

Depression is a medical illness known as a mood disorder, and it is treatable. Depression lasts longer; is far more severe; impairs work, relationships, physical and other activities; and it includes more than a sad mood. Symptoms include trouble with sleep, appetite, energy and self-esteem. The energy level at which electricity will induce a seizure. This varies for individuals and is usually higher in males and the elderly. The joule pronounced DJOOL is the standard unit of energy in electronics and general scientific applications.

One joule is defined as the amount of energy exerted when a force of one newton is applied over a displacement of one meter. One joule is the equivalent of one watt of power radiated or dissipated for one second.

The investigators also reported that high initial HAM-D scores predicted increased speed of response. This is an interesting observation that is consistent with other reports that more severely ill patients respond better to ECT. At least 2 reports suggest that younger age is associated with faster response. The first ECT in a series is particularly powerful.

Data from the CORE study that compared right unilateral, bifrontal, and bilateral electrode placements showed that there was a Symptom improvement after 1 treatment was similar for all 3 electrode placements. There is a small but fascinating literature reporting remission of depression with a single ECT session.

Keisling 6 reported an initially unidentified catatonic woman who came out of her stupor after 1 ECT session. Reports of the response of catatonia to 1 induced seizure are noted by Fink and Taylor. Thomas and Kellner 10 reported remission of severe obsessive-compulsive disorder and depression symptoms after a single unilateral session of low-dose ECT. Although unusual, these cases underscore the potentially special efficacy of the first ECT session.

Unfortunately, patients who have considerable symptom improvement after the first ECT session and who would be expected to do very well, never look as good as they did after that first treatment.

The reasons underlying such a trajectory of symptom persistence are not yet understood. What does the speed of response tell us about the mechanisms of action of ECT? Clearly, in certain patients, the neurobiological changes induced by ECT include almost immediate alterations in brain systems that regulate mood and affect. There is evidence to demonstrate that, overall, bipolar patients require fewer ECT sessions than unipolar patients.

Longer-term changes, such as synaptogenesis and neuronal regeneration, may also occur and contribute to the antidepressant and antipsychotic effects of ECT.