Speed of antidepressant response to electroconvulsive therapy. The role of electroconvulsive therapy ect in bipolar disorder. The response to ect is impressive in mania, depression and in mixed affective states. Ect was first developed in the 1930s and is most commonly used to treat people with severe depression who do not respond to medications. Electroconvulsive therapy ect is a form of electric treatment that has been used widely to reduce symptoms of depression, bipolar, and schizophrenia. Ect is safe, painless and very effective in treating depression. Electrode placement determines the geometry of the electric. Electro convulsive therapy ect is sometimes used in the treatment of bipolar disorder. In the presented case, a patient with bipolar disorder and most recent episode of mania but without psychotic feature had developed catatonia during the course of electroconvulsive therapy. The us surgeon general, the national institute of mental.
Ect involves a brief electrical stimulation of the brain while the patient is under anesthesia. The manic episode may have been preceded by and may be followed by. Ect, tms and other brain stimulation therapies nami. However, in all of these cases, other treatments should be exhausted before using ect. Electroconvulsive therapy ect is a safe and effective treatment for bipolar disorder.
Bipolar disorder paroxetine 60mgd panic disorder sertraline 150 mgday personality disorder not otherwise. When it was first used in the 1940s, it was very primitive. Pdf electroconvulsive therapy in the treatment of mixed. It may be recommended when symptoms are severe or other forms of. Electroconvulsive therapy for bipolar disorder in adults ect involves sending an electric current through the brain to cause a controlled seizure.
Electroconvulsive therapy ect is a nonpharmacologic treatment indicated for symptoms of severe mental illnesses, including psychosis, mania, catatonia, and depression. Pdf on nov 28, 2014, ute kessler and others published electroconvulsive therapy for bipolar disorder depression effects on depressive symptoms and cognitive function. Electroconvulsive therapy ect is a medical treatment for severe depression, mania and schizophrenia. Electroconvulsive therapy ect, formerly known as electroshock therapy, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from mental disorders typically, 70 to 120 volts are applied externally to the patients head resulting in approximately 800 milliamperes of direct current passed through the brain, for 100. Pdf on nov 28, 2014, ute kessler and others published electroconvulsive therapy for bipolar disorder depression effects on depressive symptoms and cognitive function find, read and cite all. Electroconvulsive therapy ect is a major treatment of catatonia. Electroconvulsive therapy in the treatment of mixed states in bipolar disorder. In clinical practice, ect is used in both major depressive disorder mdd and bipolar depression although the strength of evidence for bipolar depression is lower. This fact sheet will help you to learn more about this type of treatment. It isnt entirely understood why the seizure is effective, but its thought that it eases the symptoms of. If youve seen the movie one flew over the cuckoos nest, you may recall the fearsome side effects of. Electroconvulsive therapy has a high success rate for treating both unipolar and bipolar depression, and mania. Its often used to treat severe forms of depression or mania in bipolar i disorder when medicines.
Ect treatments can provide a fast and considerable reduction of symptoms for people with severe depression as well as other mental health conditions, which can include. Bipolar disorder and electroconvulsive therapy ect webmd. Electroconvulsive therapy for bipolar disorder depression. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Ect was first developed in the 1930s and is most commonly used to treat people with. When treatments such as medication and therapy arent able to relieve the symptoms of depression or another mental health condition, there are other options available. Its often used to treat severe forms of depression or mania. In some cases of treatment resistant bipolar disorder, ect may be considered as a treatment option. In many countries including india electroconvulsive therapy ect is frequently used to treat different phases of bipolar disorder. During this brain stimulation procedure, a health care professional passes an electric current. It is typically administered by a team of trained medical professionals. Electroconvulsive therapy, also known as ect, is a medical treatment performed under general anesthesia to treat a variety of mental health conditions, including major depression and bipolar disorder. Treating bipolar disorder 3 introduction treating patients with bipolar disorder. Electroconvulsive therapy for bipolar disorder in adults.
Electroconvulsive therapy ect is a medical treatment for severe mental illness in which a small, carefully controlled amount of electricity is introduced into the brain. We identified english language reports allowing this comparison. Efficacy of electroconvulsive therapy in bipolar disorder. Electroconvulsive therapy ect is a procedure during which an electric current is passed briefly through the brain via electrodes applied to the scalp to induce generalized seizure activity aimed at reducing refractory acute behavioral health symptoms. We evaluated the effectiveness of electroconvulsive therapy ect in the treatment of bipolar disorder bd in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features. The aim of the treatment is to relieve the symptoms of some mental health problems. In the case of schizophrenia, the effectiveness of ect is greater when duration of illness is relatively brief or when catatonic or affective symptoms are prominent.
Retrospective data were collected from all bipolar patients submitted to acute ect treatment, between june 2006. Electroconvulsive therapy s a safe and effective treatment for both manic and depressive symptoms. Electroconvulsive therapy canadian psychiatric association. Electroconvulsive therapy is not a required subject in us medical schools and not a required skill in psychiatric residency training. Electroconvulsive therapy ect is a nonmedication medical treatment that addresses severe psychiatric symptoms, after trials of medications and psychotherapy have been unsuccessful or a mental health disorder is determined to be severe and acute enough to warrant this intervention.
Electroconvulsive therapy ect is used in patients with. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. The memberguardian has given consent for the ect procedure. How is electroconvulsive therapy ect used to treat bipolar. Speed of antidepressant response to electroconvulsive. Treatments aim to stabilize a persons mood and help them manage other symptoms. Current status of electroconvulsive therapy for mood. Although the prevalence of treatmentresistant bipolar depression appears to be relatively high, few randomized controlled trials have been conducted for this. Electroconvulsive therapy ect is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. Electroconvulsive therapy ect is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. In some cases, a persons mood changes can be severe.
We selected clinical studies of ect in both mdd and bpd that reported treatment numbers in each group. Use of electroconvulsive therapy in bipolar depression mauricio tohen, m. Poon sh, sim k, sum my, kuswanto cn, baldessarini rj. A 21yearold woman, with a known case of bipolar disorder in manic phase without psychotic feature. During electroconvulsive therapy ect, a specialized doctor uses a controlled electrical current. Effectiveness in 522 patients with bipolar depression, mixedstate, mania and catatonic features.
Electroconvulsive therapy in obsessivecompulsive disorder. It involves passing an electric current through the brain to create an artificial seizure. Over 7500 australians and 300 new zealanders have ect treatment each year. We present a patient with bipolar disorder who developed catatonia during ect. A psychiatrist might suggest electroconvulsive therapy ect or other forms of brain stimulation. She had no history of brain trauma or any other medical conditions. To evaluate the efficacy and safety of electroconvulsive therapy ect in bipolar disorder bpd. Bipolar disorder treatment electroconvulsive therapy ect one of the more successful nonmedical therapies available to bipolar patients is electroconvulsive therapy ect. Is ect used to treat the mania of bipolar disorder. Clinical experience and evidencebased research have provided support for the ef. Limited evidence supports the use of ect in these patients.
Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. Apr 04, 2020 electroconvulsive therapy ect is an effective treatment for clinical depression or major depression, as well as in some forms of recurrent or chronic clinical depression with one big caveat. Ect seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions. Electroconvulsive therapy ect is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments. Somatic treatments for severe bipolar disorder the lancet. The role of electroconvulsive therapy ect in bipolar. A quick reference guide is a summary and synopsis of the american psychiatric associations practice guideline for the treatment of patients with bipolar disorder,which was originally published in the american journal of psychiatryin april 2002. Member has been medically cleared and there are no contraindications to ect i. Bipolar disorder treatment hospitalization and electroconvulsive therapy rashmi nemade, ph. Electroconvulsive therapy for manic state with mixed and. During electroconvulsive therapy ect, a specialized doctor uses. How is electroconvulsive therapy ect used to treat. Privileging for ect practice at institutions is a local option.
Pdf efficacy and safety of electroconvulsive therapy in. After acute series of ect, the ect longterm treatment may be considered, although this practice may vary significantly between countries or even within the same country. Ect is highly effective for mixed episodes and people who are severely depressed. We aim to report our experience on treating bipolar mixed states with ect. Clinical experience and evidencebased research have provided support for the efficacy of electroconvulsive therapy ect for unipolar depressive episodes, but the relative efficacy of ect in treatmentresistant bipolar depression remains understudied. Evidencebased options for treatmentresistant adult bipolar disorder patients. Pdf electroconvulsive therapy for bipolar disorder.
Neuroimaging research has identified statespecific areas of aberrant brain activity that may serve as targets for therapeutic brain stimulation. Electroconvulsive therapy definition of electroconvulsive. This electrical stimulation, used in conjunction with anesthesia and muscle relaxant medications, produces a mild generalized seizure or convulsion. Electroconvulsive therapy ect is an effective treatment option for patients that suffer from severe depression with response rates of 65. For a diagnosis of bipolar i disorder, it is necessary to meet the following criteria for a manic episode. Bipolar depression, which dominates the longitudinal course of bipolar disorder, is associated with psychosocial and. Medications are the primary means of treatment for bipolar disorder, but they are by no means the only useful bipolar disorder treatments that exist. Electroconvulsive therapy ect is a procedure where electric currents are directed to the brain.
Electroconvulsive therapy ect is effective treatment for a bipolar disorder manic episode that cannot be treated with mood stabilizers or other medications. Preliminary evidence also suggests benefit from maintenance ect in bipolar disorder. Electroconvulsive therapy electrode placement for bipolar. Also, she did not have any history of autistic disorder or benzodiazepine withdrawal. Ect involves a small electrical current being carefully passed through the brain. Furthermore, international guidelines for the treatment of bipolar disorder recommend electroconvulsive therapy as either a primary or secondary intervention for patients with severe or treatmentresistant or both bipolar disorder in all three phases of the illness. Once called electroshock therapy, ect still has many negative associations. Jan 14, 2016 electroconvulsive therapy ect was originally called electric shock therapy, and the idea for its usefulness as a treatment emerged after experts observed schizophrenic patients get better. Mar 01, 2019 bipolar disorder is a lifelong condition. After acute series of ect, the ect longterm treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal. Is electroconvulsive therapy effective for depression and. Electroconvulsive therapy ect is an effective treatment for all bipolar states.
Bipolar depression, which dominates the longitudinal course of bipolar disorder, is associated with psychosocial and cognitive impairment and with significant total health care costs. Electroconvulsive therapy ect is an effective treatment for clinical depression or major depression, as well as in some forms of recurrent or. Electroconvulsive therapy for bipolar disorder depression effects on depressive symptoms and cognitive function ute kessler dissertation for the degree philosophiae doctor phd. Ect electroconvulsive therapy for bipolar disorder. However, ect remains underutilized, likely stemming from stigma and the risk of neurocognitive impairment. Ect is a form of medical treatment for severe depression, bipolar disorder and psychotic illnesses such as schizophrenia. However, because of the convenience of drug treatment and the stigma sometimes attached to ect therapy, ect is usually employed after all pharmaceutical treatment options have been explored. Electroconvulsive therapy, also known as ect or electroshock therapy, is a shortterm treatment for severe manic or depressive episodes, particularly when symptoms involve serious suicidal or. Retrospective data were collected from all bipolar patients submitted to acute ect treatment. This article originally appeared on on january 7th, 2016.
866 622 224 1409 1525 1302 1449 1050 721 157 1089 1141 619 810 1339 84 1385 838 745 1495 1471 1239 194 364 873 165 633 632 188 738 964 1231 1073 877 145 555 892 1159 940 1483 896 579 1427 545