Electroconvulsive therapy (ECT) is a form of electric treatment that has been used widely to reduce symptoms of depression, bipolar, and schizophrenia. The method involves administering electric pulses to a client and sustaining them at an appropriate frequency and dosage until a desired seizure effect is attained. This allows the client to have specific neurologic pathways affected to minimize psychotic and manic symptoms that are common in schizophrenia, depression, and bipolar affective disorder (BPAD). In recent years, numerous psychotropic medications have been developed as an alternative to ECT, reducing its use significantly. Although they have proved to be effective in the management of many illnesses, medications almost always carry the risk of adverse side effects. Not all individuals with mental health issues respond well to medication, and some are unable or unwilling to adhere to their pharmacologic regimen. For these individuals, ECT may still be a viable option.
Vineet Bharadwaj of the Department of Psychiatry at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, recently led a study to determine the efficacy and safety of ECT in a sample of individuals diagnosed with BPAD or depression. Using information from a 10-year study, Bharadwaj analyzed data from 67 clients with either depression or BPAD who had received ECT treatments. The study revealed that individuals with BPAD represented less than 20% of the clients that underwent ECT throughout the study period. The reasons for this could be due to the increased access to effective medication options and the increased criteria for ECT consideration.
Overall, Bharadwaj discovered that ECT resulted in a 50% response rate in clients with BPAD and those with depression. Additionally, approximately two-thirds of all the participants who received ECT went into remission. The results also showed a clear link with episode duration and remission. Specifically, the longer an episode persisted, the less likely the client was to respond well to ECT. Bharadwaj said, “This finding suggests that clinicians should not wait for too long to evaluate the efficacy of pharmacotherapy in bipolar depression, as it would reduce the chances of remission with ECT too.” One of the side effects of ECT is memory loss, but this was only realized in a minority of clients treated. Overall, the results of this recent study demonstrate that ECT is a viable and effective treatment option for some individuals with BPAD and depression.”
Bharadwaj, V., Grover, S., Chakrabarti, S., Avasthi, A., Kate, N. (2012). Clinical profile and outcome of bipolar disorder patients receiving electroconvulsive therapy: A study from North India. Indian Journal of Psychiatry, 54.1, 41-47.
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