Electroconvulsive Therapy (ECT): Characteristics And Uses In Psychiatry
Throughout history, the treatment offered by psychiatry for some types of mental disorders and alterations has been strongly criticized. Specifically, electroconvulsive or “electroshock” therapy is one of those that enjoys the worst reputation in society.
However, over time this technique has been perfected and Electroconvulsive therapy is currently carried out safely and effectively Throughout this article we will talk about its characteristics, its results and its possible risks.
Electroconvulsive therapy (ECT) also known as electroconvulsotherapy consists of a psychiatric treatment, whose beginnings date back to the 1930s and which was devised with the aim of relieving the symptoms of certain mental disorders and disorders.
To do this, electroconvulsive therapy uses devices that transmit electrical energy that They send a series of electrical impulses from the outside to the patient’s brain This impulse causes a small cerebral seizure that can last from 30 seconds to two full minutes.
Although electroshock therapy has traditionally been considered an inhumane method that involves torture of the patient, currently this technique has advanced a lot. Besides, The patient is given general anesthesia so the patient remains asleep during the session and does not become conscious or feel any pain.
In this type of therapy, there are three essential variables that regulate its application:
However, despite the progress, This technique continues to carry some risks to the patient’s health so it is not usually resorted to except in those cases in which the patient does not respond satisfactorily to therapy with psychotropic drugs.
Currently, it is estimated that approximately one million people in the world’s population receive electroconvulsive therapy. This is a relatively low figure considering the number of the total population that has a psychiatric diagnosis. Likewise, the main criticism is that, in addition to the associated risks, The effects of electroconvulsive therapy are quite limited in time so after the intervention the patient must continue with the medication.
For what pathologies is it applied?
Electroconvulsive therapy It is applied as a second-line treatment in certain psychological disorders such as depression, mania and other mental illnesses in which medications are ineffective, when the clinical picture is so severe or dangerous that drug therapy is not expected to have any effect, or in pregnant patients at high risk of harm for the fetus.
This type of intervention has been shown to be effective in the treatment of the following disorders, causing a rapid and considerable reduction in the most serious symptoms It is usually used in the following cases.
1. Severe depression
ECT is particularly effective in cases of severe depressive disorder, especially if it is characterized by presenting psychotic symptoms such as disconnection from reality or if suicidal thoughts manifest.
2. Resistant depression
In this case, it is used when the symptoms of severe depression persist over time regardless of the pharmacological treatments administered.
3. Severe mania
Within bipolar disorder, electroconvulsive therapy can be used when the patient is in a state of intense euphoria characteristic of this alteration. This state is usually accompanied by impulsive behaviors, drug use and psychosis.
Catatonia is characterized by the loss of movement or the manifestation of accelerated and abnormal movements. Although it is often caused by an organic disease, It is usually related to schizophrenia and other psychiatric disorders of a psychotic type.
5. Dementia
Electroconvulsive therapy may be common in patients with dementia who They have high levels of nervousness and aggressiveness Which are resistant to treatment and reduce the patient’s quality of life.
What is the procedure?
Before starting electroshock therapy, the patient must undergo a thorough evaluation that includes the patient’s medical history, a physical examination, psychiatric evaluation, and physical tests, including: blood tests, electrocardiogram and a report from the anesthetist are found
The purpose of these tests is to ensure that electroconvulsive therapy is safe for the patient, thus ensuring the minimum possible risks or side effects.
Once the parameters or variables mentioned at the beginning of the article have been established, the treatment session begins. First of all, general anesthesia is administered and intravenous lines are placed that will provide the patient with fluids and anticonvulsant medications.
Next, Pads with electrodes are placed on one or both sides of the head , depending on whether the current must be administered unilaterally or bilaterally. The session usually lasts between 5 and 10 minutes without taking into account the time the person needs to prepare, as well as to recover from the treatment.
When this is finished, the patient is transferred to a recovery room where the patient is observed and monitored in case he or she manifests any adverse reaction. It is common to experience a feeling of confusion or disorientation when waking up.
Finally, hospitalization of the patient is not necessary, but in many cases it can be done on an outpatient basis.
What results does it offer?
Although it is still not known exactly how electroconvulsive therapy causes the brain changes that help in the patient’s recovery, the patient usually shows significant improvement after the sixth session of ECT, although an absolute remission can take much longer or even be impossible in some cases.
Because the improvement in symptoms is usually temporary, in many cases the patient must continue with pharmacological treatment or even require continuous electroconvulsive treatment.
What are the risks?
Yes ok The side effects or risks of electroconvulsive therapy have greatly decreased since its creation we can still find some unwanted consequences that can be annoying or distressing for the person.
