ECT

Question 1

INDICATIONS

Answer 1

• predominantly severe depression, specially efective in older adults
• for following features of depression: suicidal intent, psychotic features/stupor, antidepressant-resistant/not tolerated, life-threatening poor fluid intake.
• established mania, but can precipitate manic episode in bipolar.
• catatonic states, +ve Sx in schizophrenia; schizoaffective disorders.
• puerperal psychosis

Question 2

ADMINISTRATION

Answer 2

• usually 2-3x/week, up to 4-12 tx.

- induced GA effect for 5 mins

Question 3

SIDE EFFECTS

Answer 3

1. Memory impairment
   - can be reduced w unilat. electrode placement
   - diff to prove w long term studies
2. Headache, nausea, confusion, mild muscle pain in 80% pts.
3. Prolonged seizures
   - antidep and antipsychotics decrease seizure threshold.
   - benzodiazepines increase it

Question 4

CONTRAINDICATIONS

*no absolute CI

Answer 4

1. Heart disease
2. Raised ICP
3. Risk of cerebral bleeding
4. Poor anaesthetic risk