Electroconvulsive therapy (ECT): characteristics and uses in psychiatry

Throughout history, the treatment offered by psychiatry for certain types of mental disorders and disorders has been heavily criticized. Specifically, electroconvulsive therapy or “electroconvulsive therapy” is one of the most popular in society.

However, over time, this technique has been perfected and At present, electroconvulsive therapy is performed safely and effectively. Throughout this article, we will talk about its features, results, and possible risks.

    What is electroconvulsive therapy?

    Electroconvulsive therapy (ECT), also known as therapy such as electroconvulsive therapyIt is a psychiatric treatment that began in the 1930s and was designed to relieve the symptoms of certain mental disorders and disorders.

    For this, electroconvulsive therapy uses devices for the transmission of electrical energy which they send a series of electrical impulses from outside to the patient’s brain. This impulse causes a small concussion that can last anywhere from 30 seconds to two full minutes.

    Although electroconvulsive therapy is traditionally regarded as an inhuman method and involves the torture of the patient, today this technique has come a long way. Outraged, the patient receives general anesthesia, So that the patient remains asleep during the session and does not become conscious or feel any pain.

    In this type of therapy, three essential variables regulate its application:

    • The location or placement of the electrodes.
    • The duration of the pulse.
    • The electro-physical properties of stimulation.

    However, despite the advances, this technique continues to present risks to the health of the patientThus, it is usually only used in cases where the patient does not respond satisfactorily to therapy with psychotropic drugs.

    Currently, it is estimated that around one million people in the world’s population are receiving electroconvulsive therapy. This is a relatively low number considering the total number of people who have a psychiatric diagnosis. In addition, the main criticism is that in addition to the associated risks, the effects of electroconvulsive therapy are quite limited in time, So that after the intervention, the patient should continue with the drug.

    What pathologies does it apply to?

    Electroconvulsive therapy it is applied as a second-line treatment in certain psychological disorders such as depression, mania and other mental illnesses in which drugs are not effective, when the clinical picture is so severe or dangerous that drug treatment should not work, or in pregnant patients at risk high fetal damage.

    This type of intervention has been shown to be effective in the treatment of the following disorders, causing a rapid and considerable decrease in the most severe symptomatology. Usually used in the following cases.

    1. Severe depression

    TEC is particularly effective in cases of severe depressive disorder, especially if it is characterized by psychotic symptoms as a disconnection from reality or if suicidal thoughts are manifested.

    2. Depression resistant

    In this case, it is used when the symptoms of severe depression persist over time regardless of the pharmacological treatments administered.

    3. Severe mania

    In bipolar disorder, electroconvulsive therapy may be used when the patient is in a state of intense euphoria specific to this alteration. This condition is often accompanied by impulsive behaviors, drug use, and psychosis.

    4. Catatonia

    Catatonia is distinguished by loss of movement or the manifestation of accelerated and abnormal movements. Although it is often caused by organic disease, it is usually linked to schizophrenia and other psychiatric disorders of the psychotic type.

      5. Dementia

      Electroconvulsive therapy may be common in patients with dementia they exhibit high levels of nervousness and aggression. Which resist treatment and reduce the patient’s quality of life.

        What is the instruction?

        Before starting electroconvulsive therapy, the patient should undergo a thorough evaluation which includes the patient’s medical history, physical examination, psychiatric evaluation, and physical tests including blood tests, EKG and anesthesiologist report are found.

        The purpose of these tests is to make sure that the electroconvulsive therapy is safe for the patient, thus ensuring the minimum of risks or possible side effects.

        Once the parameters or variables mentioned at the beginning of the article have been established, the treatment session is carried out. First, general anesthesia is administered and the intravenous lines are placed to supply the patient with fluids and anticonvulsant drugs.

        Then, the pads with the electrodes are placed on one or both sides of the head, Depending on whether the current is to be administered unilaterally or bilaterally. The session usually lasts between 5 and 10 minutes regardless of how long the person needs to prepare, as well as to recover from treatment.

        When this is complete, the patient is taken to a recovery room where the patient is observed and monitored for any adverse reactions. It is common to feel confused or disoriented upon waking up.

        Finally, it is not necessary to hospitalize the patient, but in many cases it can be done on an outpatient basis.

        What results does it offer?

        While it is not yet clear exactly how electroconvulsive therapy causes the brain changes that help the patient to recover, it usually shows significant improvement from the sixth session of TEC, although absolute remission can take much longer or even impossible in some cases.

        Because improvement in symptoms is usually temporary, on many occasions the patient should continue pharmacological treatment or even require continuous electroconvulsive treatment.

        What are the risks?

        even if the side effects or risks of electroconvulsive therapy have greatly decreased since its inceptionWe can still find unwanted consequences which can be annoying or distressing for the person.

        These side effects include:

        • Retrograde amnesia or memory loss of what happened moments before treatment or during the weeks of treatment.

        • Sensation of temporary confusion.
        • Headache.
        • Hypotension or hypertension.
        • Tachycardia or heart problems.
        • Muscle pain.
        • nausea.

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