Other Treatments Electroconvulsive Therapy

Electroconvulsive therapy (ECT) involves a brief electrical stimulation of the brain while the patient is anesthetized, inducing a seizure. ECT remains the most effective treatment for depression (UK ECT Group, 2003), although the stigma surrounding the treatment, misinformation about its practice, side effects, and cost have often made it a treatment of last resort. Although occasionally used as first-line therapy for severe depression, ECT is often used for multitreatment-refractory patients, those with psychotic depression, suicidal patients (imminent), and depressed patients with compromised oral intake. A typical course is six to 20 treatments, with patients receiving ECT three times a week during the acute phase, gradually increasing the time between treatments as improvement becomes apparent. After acute treatment, patients are often returned to antidepressant therapy, although medication efficacy after ECT does not appear to be enhanced (Kellner et al., 2006). Physicians should be aware that ECT is safe, well tolerated, humane, and effective.

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