Case Analysis : Electroconvulsive Therapy

Electroshock therapy is the process of electroshocking the brain of a human, this a process that takes multiple sessions (CBS News). ECT caused critical seizures. Doctors used this method to cure of reduce schizophrenia. Electroshock therapy was performed daily, it was known referred to as “The shock of the day” (D’Antonio). Doctors saw ECT as a easy and fast way to cure a patient.

Still today it is not known why ECT works but it seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It is also said that the shock literally shocks the person out of their illness as it is regarded as a punishment for the inappropriate behaviour. Another explanation is that the associated memory loss following shock allows the person to start afresh. They literally ‘forget’ they were suffering from a mental illness. Created in +1934 by Hungarian neuropsychiatrist Ladislas Meduna, [11]. However, ECT was not introduced in England until 1939 when Lothar Kalinowsky, observed the treatment administered in Italy and decided to use it in England due to its promising results. During this time high doses of electricity were administered without anaesthesia and muscle relaxations. This lead to memory loss, fractured bones and other serious side effects, which lead to, much of the stigma attached to ECT, because of these early treatments [12]. ECT is a treatment that is still used today, however much less brutally than in the 1930s.

What remains unknown is why electroconvulsive therapy is effective. A plethora of studies show the neurochemical correlates of this treatment and its relation to the anti-depressant effect, yet none are conclusive. Richard Abrams has studied ECT for years and discusses a wide variety of reasons for its effectiveness in his revised edition of Electroconvulsive Therapy. For a person who has studied this treatment for 50 years, he concludes

Epilepsy is the second prevalent neurological disorder after stroke. Approximately two-thirds of afflicted patients experience partial onset of seizures (Houser, 1997) and, in most patients, epilepsy evolves as a consequence of a brain damaging injury such as status epilepticus (SE), head trauma, or stroke (Mathern et al., 1995).

Another biological therapy is electroconvulsive therapy, which patients are injected so that they are unconscious before the electric shock is administered. (They are also given a nerve blocking agent to paralyse muscles to prevent fractures during the seizure.) A small amount of electric current, lasting about half a second is passed through the brain. This produces a seizure, lasting up to one minute, which affects the whole brain. A patient usually requires between 3 and 15 treatments.

ECT has become much safer than the dangerous past shown in One Flew Over the Cuckoo’s Nest. Electroconvulsive therapy has little resemblance to that depiction. ECT brings about fast results compared to some other medications and treatments. After the shock, there is immediate relief to the symptoms of many mental illnesses. The electric current only lasts for a few seconds and the seizure lasts for about a minute. Many medications take weeks to become effective and ECT is an ideal option for those people that need the relief right away. ECT has often worked when many other treatments have

Electroconvulsive therapy, also known as ECT, is a medical procedure that is used in the treatment of mental illness. In ECT, a small electrical impulse is sent through the brain, resulting in an ephemeral seizure. Though the process is generally effective, modern science is unaware of the explanation behind ECT's success. Its history is filled with a large amount of stigma and the use of ECT as a therapy is still debated today. ECT has evolved to a point where its beneficial effects can be maximized and its adverse effects can be minimized through proper administration.

Prior to the actual treatment, the patient is given general anesthesia and a muscle relaxant. Electrodes are then attached to the patient's scalp and an electric current is applied which causes a brief convulsion. Minutes later, the patient awakens confused and without memory of events surrounding the treatment. This treatment is usually repeated three times a week for two to four weeks. The number of treatments varies from six to twelve. It is often recommended that the patient maintain a limited intake of medication, after the ECT treatments, to reduce the chance of relapse.

When researching modern literature, one clearly sees there are still some consequences that sometimes occur with administration of the electroconvulsive therapy. This clearly proves that there are many who believe ECT is generally unsafe in nature. One of the arguments here is the high risk of relapse and recurrence

The second argument for the use of ECT is that successful treatments induce remission in episodes of illness (Gabbard, 2001). The evidence supporting this conclusion is compelling and includes a sizable number of well-controlled “sham-ECT” studies. In these studies, patients were randomized to receive real ECT or sham-ECT (which involves anaesthesia but no electrical stimulation), thus providing for precise double-blind tests of efficacy (Gabbard, 2001). One misconception is that it provides a “cure”. This is not the case - it does not produce a “cure” any

Electroconvulsive therapy (ECT), formerly known as electroshock therapy, is a treatment for mental illnesses that runs small electric currents through the brain, with the intention of bringing on a brief seizure. The goal is to change brain chemistry to reverse symptoms of certain mental illnesses. During the 1940s-50s, ECT was the most effective way of treating certain mental illnesses and was used frequently throughout many countries (Kendell, 1982). One of the main illnesses ECT is used for is depression, but it is also used for other mental illnesses, such as mania and some cases of schizophrenia. Patients undergo ECT about three times a week, totaling six to twelve sessions. This is an important topic to research because ECT is known to

Physical trauma associated with ECT, they include soft tissue damage and fractures. Physical trauma usually occurs as a consequence of a significant amount of muscle contractions while administering the treatment. Though it is more common in previous years of ECT use, in current practice, this key risk is still highly uncommon. Some probable mitigating factors to reduce or prevent the severity of physical trauma include the use of some anesthetic agents and neuromuscular blocking

Electroconvulsive therapy is a psychiatric treatment that has been controversial for all its 60 years of use. **During the last few decades, researchers have been attempting to identify whether this is an effective treatment by studying the effectiveness of ECT, to learn how and why it works, and to understand its risks and adverse side effects. However, even after years of research, it is still unclear whether this is a safe and effective method. This psychiatric treatment is being administered to hundreds of patients yearly yet no one is sure if it is helping the patients or harming them. Both sides of this controversy have two very strong and compelling arguments. Psychiatrists and researchers, such as Max Fink, who argue for this treatment,

seizure through controlled electric shock, under anesthesia. The process itself is under scrutiny because it is not entirely understood, which is main a reason why it is only considered in the direst of cases. ECT tends to have severe physical health risks and with the introduction of newer and less harmful antidepressant drugs, it is being used far less often (Comer, 2005). This new class of drugs includes three main types; monoamine oxidase (MAOI) inhibitors, tricyclics and selective serotonin reuptake inhibitors (SSRIs).

The ECT was being administered in theatre in the general hospital. In advance of the treatment the clients vital signs were checked and it was confirmed that consent was given. The client was then transferred to theatre. Present in the room was the anaesthesiology team, ECT nurse, surgical nurse, psychiatric consultant, registrar, psychiatric nurse and student nurse. Initially the client was hooked up to a machine to record her vital signs, anaesthetic and muscle relaxants were administered and the client was ventilated with 100% oxygen. Under anaesthetic the client has reduced capacity to breathe hence oxygen is administered, pure oxygen also reduces the deleterious effects on memory. Anaesthesia and muscle relaxants reduce the seizure threshold and the risk of injuries from motor activity during the seizure (Fink 2009). The client remained in the supine position, conductive jelly was applied bilaterally to the temples and the psychiatrist administered the electrical stimulus. The choice between unilateral and bilateral electrode placement remains