ECT Treatment

Electroconvulsive Therapy (ECT) in Psychiatry

• ECT can be bilateral or unilateral, with bilateral being the most common, effective, and associated with more cognitive dysfunction.
• ECT is indicated for severe depression, resistant depressive disorder, suicidal attempts, mania, acute catatonic schizophrenia, and schizoaffective psychosis.
• Contraindications include increased intracranial pressure, severe cardiovascular or pulmonary disease, active bone disease or musculoskeletal injuries, and severe anxiety disorders.
• The number of treatments varies by case, with an average of 6-10 treatments, and treatments are usually administered three times per week, not exceeding 25 times per episode.
• The exact mechanism of action of ECT is unknown, but it is believed to affect neurotransmitters such as serotonin, norepinephrine, and dopamine.
• ECT theories of action include punishment, life-threatening experience, release of aggressive impulses, minimal brain damage, and compensation for malfunctioning electric circuits in the brain.
• The phases of ECT include the cry phase, tonic phase, clonic phase, and recovery phase.
• The ECT team includes a psychiatrist, anesthesiologist, trained nurses, nurse aids, and an ECT assistant.
• The nurse's role in ECT includes pre-ECT care such as obtaining informed consent, completing physical exams and tests, reducing patient anxiety, and preparing necessary equipment and medication.
• During ECT, the nurse's role includes reassurance and support, drug administration, preventing falls or fractures, and post-seizure care.
• Side effects of ECT include headache, confusion, and temporary memory loss, while complications or risks may include brain damage, permanent memory loss, confusion, fracture, and rare instances of death.
• Ethical considerations in ECT include using the minimum number of treatments necessary, avoiding allowing patients to see or hear others receiving ECT, and avoiding considering ECT as a form of punishment.