Electric shocks - contrary to appearances - are still used in psychiatric treatment. Electroconvulsive therapy is quite an interesting issue, because it also treats other than psychiatric conditions, and sometimes electroconvulsive therapy is even safer than… psychotropic drugs. What are the indications for electroconvulsive therapy, and what effect does this therapy have on brain function?

Electroconvulsive therapy(electroconvulsive therapy) was first used in 1938. In the 1950s-1970s. In the 1980s, mental he alth professionals made frequent use of this method, later electroconvulsive therapy was performed less and less. It would seem that electric shocks are long forgotten - nothing could be further from the truth. This type of treatment is still carried out in many countries around the world, including Poland.

Electric shocks: principle of operation

The exact mechanism of electroshock action is not clear to this day. It is now believed that there are at least a few effects of electroconvulsive therapy. It is mentioned that it can affect both the levels of the neurotransmitters of the nervous system (such as serotonin, dopamine and noradrenaline) and the number of receptors for these molecules within nerve cells. Electroshock can also affect the activity of the hypothalamic-pituitary-adrenal system (considered the stress axis), and can lead to the release of various neuropeptides and neuromodulators. Electroconvulsive therapy may also result in changes in the metabolism of nerve cells (e.g. in terms of their use of glucose), as well as stimulation of blood circulation within the brain.

Electric shocks: indications for their use

Electroconvulsive therapy is not likely to be the method of first choice for psychiatric conditions. It is used in strictly defined cases - the basic indications for electroshock can be:

  • severe depressive episodes with increased suicidal tendencies or other problems that may lead to a threat to life (e.g. refusal to eat)
  • drug-resistant depression
  • long-term severe manic or psychotic episodes
  • katatonia

There are other units - not only psychiatric ones - in which electroconvulsive therapy is sometimes used. Arethem:

  • obsessive-compulsive disorder
  • episodes of marked agitation in patients with dementia
  • Parkinson's disease
  • Gilles de la Tourette's syndrome
  • dystonie
  • dyskinesia
  • epilepsy

Electroconvulsive treatment may seem dangerous, but it turns out that sometimes electroconvulsive therapy is safer than other treatment options. For example, sometimes electroconvulsive therapy is beneficial in pregnant women - it is safe for the developing fetus, while medications administered to the patient could already lead to some disorders of the child's development. The same is true for the elderly, who sometimes cannot use psychotropic drugs due to their poor he alth - in this group of patients, electroconvulsive therapy may also be a safer solution than pharmacotherapy.

Electric shocks: waveform

Scenes known from the film industry where a patient subjected to electroconvulsions experiences whole-body vibrations are alien to physicians who conduct electroshock therapy. This procedure is performed under general anesthesia, in addition, patients are given muscle relaxants - the effect of this is that the person treated with electroconvulsions lies completely calm, and only records on the monitoring equipment show about electrical discharges.

Electroconvulsive therapy is performed by a medical team in which the patient is looked after by a psychiatrist, an anesthesiologist and a nurse. In addition to the above-mentioned methods, which are to provide the patient with comfort during electroconvulsions, special protectors are also used, preventing, for example, the patient from biting the tongue. Treatment is carried out by applying electrodes to the patient's head and then generating electrical impulses. Their power and number are determined individually for each patient - the parameters are determined by determining the convulsive threshold of a given patient.

In one series of electroconvulsive treatment, a different number of treatments are performed. Usually, the patient undergoes several or a dozen treatments, but they are performed at intervals - usually electroconvulsive therapy is performed two to three times a week.

Electric shocks: contraindications

It has been mentioned that electroshock can even be used in pregnant women and the elderly. However, this is not the same as the fact that electroconvulsive therapy can be implemented in every patient - the contraindications to electroconvulsive therapy include:

  • recent stroke or heart attack
  • ailmentssevere, irregular cardiovascular disease (e.g. coronary heart disease or heart failure)
  • excessive intracranial pressure
  • acute attack of glaucoma
  • severe respiratory disease (e.g. unstable chronic obstructive pulmonary disease or pneumonia)
  • severe metabolic disorders (e.g. from diabetes or kidney failure)

Electric shocks: complications

As with any drug or surgical treatment, patients may experience complications with electroconvulsive therapy. They include both mental problems and various somatic ailments. The former include, among others confusion or memory disorders (mainly related to short-term memory). Somatic complications of electroconvulsive therapy are, in turn, muscle aches, headaches, nausea and vomiting. Patients also suffer from cardiovascular complaints (such as a transient increase in heart rate or a transient increase in blood pressure).

Electric shocks: effectiveness

Why electroshock still functions in the medical world can most likely be convinced by the effectiveness of this method of treating mental illnesses. The effectiveness of electroconvulsions varies depending on the condition being treated with them. However, general statistical data show that electroconvulsive therapy can achieve the desired effects in 7 to even 9 out of 10 patients undergoing it.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Psychiatry