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Electroconvulsive Therapy

In the 16^th Century agents to induce seizures were used to treat psychiatric conditions. The therapeutic use of seizure induction was documented in the London Medical Surgical Journal in 1785. The dawn of electricity’s therapeutic use was 1744. It was documented in the first issue of Electricity and Medicine.  Convulsive therapy was introduced in 1934 by Hungarian neuropsychiatrist Ladislas J. Meduna. He is the father of electroconvulsive therapy. The first international meeting on schizophrenia and convulsive therapy was held in Switzerland by Swiss psychiatrist Max Muller in 1937.

     Electroconvulsive therapy is a psychiatric treatment where a generalized seizure (without muscular convulsions) is electrically induced to manage mental disorders that are resistant to other forms of treatment. The disorders are major depressive disorder, mania, and catatonia. The definition of catatonia is a psychomotor disturbance that may involve muscle rigidity, stupor, or mutism, purposeless movements, negativism, echolalic and inappropriate or unusual posturing and is associated with various medical conditions (such as schizophrenia and mood disorders).¹

     In ECT treatment there is more than one therapy session. The therapy is given two or three times per week until the patient is no longer suffering with symptoms. The treatments are given under anesthesia with a muscle relaxant.

     For follow up after treatment antidepressants are given to people who have depression. Lithium has found to reduce the risk of relapse, especially in younger patients. For people with mania the therapy is used for people who are resistant to other treatments and who have severe prolonged mania. For people who have catatonia the therapy is a second line treatment for people who do not respond to other treatments, but it is a first line treatment for severe or life- threatening catatonia.

     The U.S. Surgeon General’s report says that there are “no absolute health contra indications” in the use of the therapy. The most common adverse effects are confusion, memory loss, and muscle soreness. There is an increased risk for those who have heart disease or aneurysms and those who had a stroke.

     Cognitive impairment adverse effect is relatively uncommon. Acute effects of ECT can include amnesia both retrograde (for events before treatment) and anterograde (for events after treatment). Patients who receive pulsing electrical impulses have less memory loss as opposed to those who receive steady flow of electrical impulses.

     There has been no evidence found that shows ECT causes structural damage to the brain. A 1999 report by U.S. Surgeon General states, “The fears that ECT causes gross structural brain pathology have not been supported by decades of methodologically sound research in both humans and animals.” Dr. Charles Kellner a prominent ECT researcher and former chief editor of the Journal of ECT. In a 2007 interview he stated, “There are a number of well-designed studies that show ECT does not cause brain damage and numerous reports of patients who have received a large number of treatments over their lifetime and have suffered no significant problems due to ECT.”

          ECT can cause a lack of blood flow and oxygen to the heart thereby causing heart arrhythmia. Death is very rare (6 per 100,000 treatments).

     It has been found that ECT does not cause change in a person’s personality nor does it cause dementia. It could cause a worsening of anxiety symptoms including obsessional thoughts or panic attacks.

     In ECT 15-20 minutes is the actual treatment session and there is a 20-30 minute recovery time after the session. The use of ECT was stopped in the United States in March of 2020.

     ¹ Merriam-Webster Dictionary

https://en.wikipedia.org/wiki/Electroconvulsive_therapy

Signed: Renee D. Warring of Uniquely and Wonderfully Made Ministries