A comprehensive search of medline, psycinfo, and isi web of science databases was conducted in march 2010. 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 in obsessivecompulsive disorder. 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. Speed of antidepressant response to electroconvulsive therapy. Mar 01, 2019 bipolar disorder is a lifelong condition. Retrospective data were collected from all bipolar patients submitted to acute ect treatment. The us surgeon general, the national institute of mental.
Efficacy and safety of electroconvulsive therapy in the treatment of bipolar disorder. Ect seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions. It involves passing an electric current through the brain to create an artificial seizure. 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. Ect involves a brief electrical stimulation of the brain while the patient is under anesthesia.
However, ect remains underutilized, likely stemming from stigma and the risk of neurocognitive impairment. 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. 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. Electroconvulsive therapy electrode placement for bipolar. Ect is safe, painless and very effective in treating depression. Although the prevalence of treatmentresistant bipolar depression appears to be relatively high, few randomized controlled trials have been conducted for this. Member has been medically cleared and there are no contraindications to ect i. The aim of the treatment is to relieve the symptoms of some mental health problems. In some cases of treatment resistant bipolar disorder, ect may be considered as a treatment option. Electroconvulsive therapy ect is effective treatment for a bipolar disorder manic episode that cannot be treated with mood stabilizers or other medications. The memberguardian has given consent for the ect procedure.
Ect electroconvulsive therapy for bipolar disorder. 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. She had no history of brain trauma or any other medical conditions. Electroconvulsive therapy has a high success rate for treating both unipolar and bipolar depression, and mania. 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. Electroconvulsive therapy for bipolar disorder in adults. Electroconvulsive therapy ect is a procedure where electric currents are directed to the brain. Bipolar disorder and electroconvulsive therapy ect webmd. 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. Electroconvulsive therapy definition of electroconvulsive. To evaluate the efficacy and safety of electroconvulsive therapy ect in bipolar disorder bpd. If youve seen the movie one flew over the cuckoos nest, you may recall the fearsome side effects of.
How is electroconvulsive therapy ect used to treat. How is electroconvulsive therapy ect used to treat bipolar. Treatments aim to stabilize a persons mood and help them manage other symptoms. We aim to report our experience on treating bipolar mixed states with ect. 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. Catatonia development in a patient with bipolar disorder. Bipolar disorder treatment electroconvulsive therapy ect one of the more successful nonmedical therapies available to bipolar patients is electroconvulsive therapy ect. Pdf on nov 28, 2014, ute kessler and others published electroconvulsive therapy for bipolar disorder depression effects on depressive symptoms and cognitive function. Electro convulsive therapy ect is sometimes used in the treatment of bipolar disorder. Electroconvulsive therapy for manic state with mixed and. Electroconvulsive therapy ect is a safe and effective treatment for bipolar disorder. Neuroimaging research has identified statespecific areas of aberrant brain activity that may serve as targets for therapeutic brain stimulation. The response to ect is impressive in mania, depression and in mixed affective states. We identified english language reports allowing this comparison.
Electroconvulsive therapy ect is an effective treatment for all bipolar states. Speed of antidepressant response to electroconvulsive. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. This electrical stimulation, used in conjunction with anesthesia and muscle relaxant medications, produces a mild generalized seizure or convulsion. Electroconvulsive therapy in the treatment of mixed states in bipolar disorder. Bipolar disorder treatment hospitalization and electroconvulsive therapy rashmi nemade, ph. 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. Electroconvulsive therapy ect is a major treatment of catatonia.
Electroconvulsive therapy for bipolar disorder depression effects on depressive symptoms and cognitive function ute kessler dissertation for the degree philosophiae doctor phd. Electroconvulsive therapy is not a required subject in us medical schools and not a required skill in psychiatric residency training. During this brain stimulation procedure, a health care professional passes an electric current. Somatic treatments for severe bipolar disorder the lancet. 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. 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. Pdf efficacy and safety of electroconvulsive therapy in the. When it was first used in the 1940s, it was very primitive. Ect is a form of medical treatment for severe depression, bipolar disorder and psychotic illnesses such as schizophrenia. Clinical experience and evidencebased research have provided support for the ef.
Ect involves a small electrical current being carefully passed through the brain. Pdf efficacy and safety of electroconvulsive therapy in. Use of electroconvulsive therapy in bipolar depression mauricio tohen, m. Once called electroshock therapy, ect still has many negative associations. Ect, tms and other brain stimulation therapies nami. Is electroconvulsive therapy effective for depression and. Is ect used to treat the mania of bipolar disorder. The manic episode may have been preceded by and may be followed by.
Electroconvulsive therapy, or ect for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain also known as a seizure. Ect was first developed in the 1930s and is most commonly used to treat people with. It isnt entirely understood why the seizure is effective, but its thought that it eases the symptoms of. 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. Electroconvulsive therapy ect is a medical treatment for severe depression, mania and schizophrenia. This fact sheet will help you to learn more about this type of treatment.
This article originally appeared on on january 7th, 2016. Poon sh, sim k, sum my, kuswanto cn, baldessarini rj. Effectiveness in 522 patients with bipolar depression, mixedstate, mania and catatonic features. Ect is highly effective for mixed episodes and people who are severely depressed. Pdf electroconvulsive therapy in the treatment of mixed. 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. Electroconvulsive therapy ect is a nonpharmacologic treatment indicated for symptoms of severe mental illnesses, including psychosis, mania, catatonia, and depression. 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.
Also, she did not have any history of autistic disorder or benzodiazepine withdrawal. Over 7500 australians and 300 new zealanders have ect treatment each year. Electroconvulsive therapy s a safe and effective treatment for both manic and depressive symptoms. A psychiatrist might suggest electroconvulsive therapy ect or other forms of brain stimulation. Its often used to treat severe forms of depression or mania.
For a diagnosis of bipolar i disorder, it is necessary to meet the following criteria for a manic episode. Electroconvulsive therapy for bipolar disorder in adults ect involves sending an electric current through the brain to cause a controlled seizure. The role of electroconvulsive therapy ect in bipolar. During electroconvulsive therapy ect, a specialized doctor uses a controlled electrical current. Electrode placement determines the geometry of the electric. 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. In many countries including india electroconvulsive therapy ect is frequently used to treat different phases of bipolar disorder. 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.
Bipolar depression, which dominates the longitudinal course of bipolar disorder, is associated with psychosocial and cognitive impairment and with significant total health care costs. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Evidencebased options for treatmentresistant adult bipolar disorder patients. We present a patient with bipolar disorder who developed catatonia during ect. Current status of electroconvulsive therapy for mood. 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. During electroconvulsive therapy ect, a specialized doctor uses. The role of electroconvulsive therapy ect in bipolar disorder. Limited evidence supports the use of ect in these patients. Treating bipolar disorder 3 introduction treating patients with bipolar disorder. 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.
Mood disorders association of bc electro convulsive therapy ect is sometimes used in the treatment of bipolar disorder. Electroconvulsive therapy canadian psychiatric association. Electroconvulsive therapy ect is used in patients with. 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 for bipolar disorder depression. Electroconvulsive therapy ect is an effective treatment for clinical depression or major depression, as well as in some forms of recurrent or. Use of electroconvulsive therapy in bipolar depression. We selected clinical studies of ect in both mdd and bpd that reported treatment numbers in each group. In some cases, a persons mood changes can be severe. Its often used to treat severe forms of depression or mania in bipolar i disorder when medicines. It may be recommended when symptoms are severe or other forms of. 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.
Electroconvulsive therapy ect is an effective treatment option for patients that suffer from severe depression with response rates of 65. 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. Bipolar disorder paroxetine 60mgd panic disorder sertraline 150 mgday personality disorder not otherwise. A 21yearold woman, with a known case of bipolar disorder in manic phase without psychotic feature. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. Privileging for ect practice at institutions is a local option. Preliminary evidence also suggests benefit from maintenance ect in bipolar disorder. Ect was first developed in the 1930s and is most commonly used to treat people with severe depression who do not respond to medications. Bipolar depression, which dominates the longitudinal course of bipolar disorder, is associated with psychosocial and. Retrospective data were collected from all bipolar patients submitted to acute ect treatment, between june 2006. Electroconvulsive therapy ect is a form of electric treatment that has been used widely to reduce symptoms of depression, bipolar, and schizophrenia. 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. However, in all of these cases, other treatments should be exhausted before using ect. Efficacy of electroconvulsive therapy in bipolar disorder.
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