- Electroconvulsive therapy: invented decades ago, still used today
- Indications for electroconvulsive therapy
- Is the fear of electroconvulsive therapy really justified?
- Effectiveness of electroconvulsive therapy
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VERIFIED CONTENTAuthor: lek. Tomasz NęckiElectroconvulsive therapy is still a method of treatment used in psychiatry. Using it may be advisable, inter alia, in patients with schizophrenia, bipolar disorder or depression. When else may it be necessary to use electroshock?
Psychiatric treatment is primarily associated with taking various pharmaceuticals. The use of psychotropic drugs is one of the main methods of treating mental disorders and diseases. However, this is not the only possible therapeutic option. In addition to psychotherapy, which plays a significant role, modern psychiatry also uses surgical procedures (sometimes referred to as psychosurgical) and electroshock therapyi.
Electroconvulsive therapy: invented decades ago, still used today
Electric shock began to be used in psychiatry in the first half of the last century and for this reason the method could be considered one of those that have long ago become obsolete. In practice, however, this is definitely not the case. Electroconvulsive therapy is performed in the most recognized clinical centers around the world, including Poland.
Despite the fact that electroconvulsive therapy has been known to the medical world for decades, it is still not fully known what its mechanism of action is. It has been suggested that the procedure may result in changes in the concentrations of various neurotransmitters (such as serotonin or dopamine) in the central nervous system, as well as in the secretion of certain neuropeptides or neuromodulators in the brain.
It is possible that electroshock changes the number of receptors for neurotransmitters on nerve cells, and the procedure may also result in a modification of the activity of the hypothalamic-pituitary-adrenal axis (it is sometimes referred to as the stress axis and it is postulated that activities may contribute to the development of certain mental disorders).
Ultimately why electroconvulsive therapy works is simply impossible to say. Treatment with its use may bring the expected results, but it is not intended for all patients with disorderspsychological.
Indications for electroconvulsive therapy
It is not hard to guess that electroconvulsive therapy is not the first line treatment for mental disorders. They are usually used when other methods - usually pharmacotherapy - have not achieved the optimal treatment effect.
Electroconvulsive therapy is most often used in severe suicidal depressive disorders and treatment-resistant forms of bipolar disorder or schizophrenia.
Treatments can be performed in people experiencing catatonia, but also when the patient's life is threatened in the course of a mental illness, e.g. due to a complete refusal to take food and fluids.
The above-mentioned units are not the only possible indications for electroconvulsive therapy.
The procedure can also be used in the case of other psychiatric problems, the treatment of which using separate methods does not bring adequate results and ultimately patients with such entities as obsessive-compulsive disorder (OCD) or dementia may be subjected to electroconvulsive therapy.
Interestingly, not only mental disorders can be an indication for electroconvulsive therapy - treatments are also used in the treatment of epilepsy or Gilles de la Tourette's syndrome.
Is the fear of electroconvulsive therapy really justified?
As hardly anyone has seen electroshock therapy in a hospital, many more people have had the opportunity to see the course of this procedure presented in various film productions.
If we were to rely solely on movies, then indeed - electroconvulsive therapy would be very scary. Usually, it is presented as a brutal method of treatment, where during treatments the patient's whole body is torn by severe convulsions. In fact, the whole procedure is different.
Patients undergoing electroconvulsive therapy receive muscle relaxants so that they lie completely still during the procedure. The procedure itself is supervised by the treatment team, and the patient is monitored and his various vital signs are assessed on an ongoing basis.
It is worth emphasizing here that sometimes electroconvulsive therapy is sometimes safer than other treatments used in psychiatry. We can even mention the elderly, for whom pharmacotherapy may not be indicated due to some chronic or medical conditions.also because psychotropic drugs led to some serious side effects in the patient. It is similar in pregnancy, where electroconvulsive therapy can be a safer method of treating mental disorders than pharmacotherapy.
The safety of electroconvulsive therapy is influenced not only by the proper conduct of the entire procedure, but also the appropriate qualification for the procedure. There are some contraindications to using electroconvulsive therapy - they include, among others, having a stroke or heart attack shortly before the procedure, severe metabolic disorders (resulting, for example, from liver or kidney dysfunction), or cardiovascular or unstable respiratory diseases (such as, for example, chronic obstructive pulmonary disease or ischemic heart disease).
Effectiveness of electroconvulsive therapy
For people who are to undergo some treatment, it is important not only whether the procedure is safe, but also whether using it can bring the desired treatment results.
The effectiveness of electroconvulsive therapy can be considered rather high - it is estimated that positive results are obtained in 70 to even 90% of patients treated with this method.
It is worth noting, however, that to obtain improvement, it is not enough to use electroshock therapy once - typically the patient undergoes several or a dozen treatments, which are carried out with intervals of several days.