Why did doctors do or are doing electroconvulsive and electroshock
 therapy?

Why did doctors do or are doing electroconvulsive and electroshock therapy?

The Dangerous History of Electroconvulsive Therapy, and How It's Used Today

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answers (3)

Answer 1
January, 2021

Today, there are fundamental ideas about indications for ECT: in psychiatry, the reference indications for its use are depressive and catatonic syndromes, in neurology - Parkinson's disease and Parkinson-like conditions.

There is not a single absolute contraindication to treatment ECT method and only one relative contraindication - a large unstable intracranial tumor with the danger of penetration into the foramen magnum.

Viewing ECT as a "therapy of despair" or "the last resort when other methods have not worked" has long been obsolete (ECT Instructions for Use, 1979).

With no mental illness, you can never be completely sure that ECT will not be beneficial - there is always a chance of success.

ECT is the method of choice in the treatment of psychotic conditions in pregnant women due to the lack of teratogenic effect.

There are emergency and planned indications for ECT. To date, only 4 indications have been recognized as emergency:

  1. febrile catatonia;
  2. neuroleptic malignant syndrome;
  3. depression with an indomitable urge to commit suicide and self-harm;
  4. psychopathological conditions with persistent refusal of food and water, which leads to dehydration and an increase in somatic disorders.

The remaining indications are planned.

The planned indications include psychoses of any origin (both schizophrenic and organic, senile, postpartum, vascular, post-traumatic, etc.), depression in the structure of a wide variety of diseases (these can be both bipolar affective disorders and depression in cancer, etc.), catatonia outside of its connection with nosology (i.e., regardless of origin), resistance to psychopharmacotherapy or its intolerance.

In addition, ECT is successfully used in neurology for the treatment of Parkinson's disease and Parkinson-like conditions, it increases the seizure threshold and reduces seizures in epilepsy, is used to treat chronic pain syndrome, alleviate the course of Huntington's chorea and multiple sclerosis.

Recent studies in neuro-mapping of the brain show the pathophysiological similarity of craving for alcohol (or drugs) with depression, which makes it possible to successfully use ES T and in narcology.

At the same time, of course, ECT is not a panacea, and the prediction of the effectiveness of a particular method of treatment, the selection of the necessary therapy is carried out by the attending physician individually in relation to each individual patient.

Answer 2
January, 2021

ECT is a dangerous method, and as already said, it is used as a last resort. A more controlled method is insulinoma therapy. As the name implies, a person is given an intravenous infusion of insulin to a superficial coma and then withdrawn from it. You can control your blood glucose and do everything smoothly. In terms of effectiveness, these methods are comparable.

Answer 3
January, 2021

Because electroconvulsive therapy (ECT) is currently the most effective treatment for acute mental illness. But due to the large number of contraindications and the risk of complications, it is used only in exceptional cases, when all other methods of treating the patient have been tried.

With this method, a person is put into an unconscious state (anesthesia), electrodes are attached to his head, through they are given an electric current, a large epileptic seizure develops. Several such sessions are required. Simply put, ECT reboots the neurons. It's like with a computer - if it crashes, then the surest way to get it back to work is to restart it.

I saw with my own eyes how ECT worked wonders. For example, a 19-year-old boy enrolled - a student at the Polytechnic University. He suffered an acute attack of catatonic schizophrenia. He ran around the room, uttered ridiculous phrases and syllables, made stereotypical movements (shaking his head, waving his arms, dancing, approaching everyone - touching, feeling, hitting). At the same time, he was completely unavailable to the contact. The eyes were blank and insane. This went on for many days (it cures all day, sleeps at night - the next day everything was repeated). No drugs worked on him (they only caused sleep, in the morning it all started again). It seemed like the guy was lost forever. He gave the impression of a Mowgli, although he had previously been quite an ordinary student.

And by the decision of the medical commission, he was assigned ECT. With each session, he became calmer, more orderly. And in the end, after a few days, his seizure ended. He returned to his previous state. Became an adequate, ordinary guy. Described memories of psychosis as a dream, "everything was in a fog", "I did not control myself."

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