Electroconvulsive therapy (ECT): characteristics and uses in psychiatry

This type of psychiatric intervention has evolved greatly over time, and no longer causes pain.

Throughout history, the treatment offered by psychiatry for some types of mental disorders and disturbances has been strongly criticized. In particular, electroconvulsive or "electroshock" therapy is one of the most infamous in society.

However, with the passage of time this technique has been perfected and nowadays electroconvulsive therapy is Today, electroconvulsive therapy is carried out in a safe and effective manner.. Throughout this article we will talk about its characteristics, its results and its possible risks.

What is electroconvulsive therapy?

Electroconvulsive therapy (ECT), also known as electroconvulsive therapy (ECT).ECT is a psychiatric treatment, the beginnings of which date back to the 1930s and which was devised with the aim of alleviating the symptoms of certain mental disorders and disorders.

For this purpose, electroconvulsive therapy uses electrical energy transmitting devices that send a series of electrical impulses to the patient. electrical impulses from the outside to the patient's brain, which are then sent to the patient's brain.. This impulse causes a small brain seizure whose duration can range from 30 seconds to two full minutes.

Although electroshock therapy has traditionally been considered an inhumane method that involves torture of the patient, this technique has nowadays advanced considerably. In addition, the patient is administered with an anesthetic, the patient is administered a general anesthesia, so the patient is kept under general anesthesia.The patient remains asleep during the session and does not become conscious or feel any pain.

In this type of therapy, there are three essential variables that regulate its application:

• The location or placement of the electrodes..
• The duration of the impulse.
• The electrophysical properties of the stimulation.

However, in spite of the advances, this technique continues to carry some risks for the patient's health.Therefore, it is not usually resorted to except in cases where the patient does not respond satisfactorily to therapy with psychotropic drugs.

At present, it is estimated that approximately one million people in the world's population receive electroconvulsive therapy. This is a relatively low figure considering the number of the total population with a psychiatric diagnosis. Also, the main criticism is that, in addition to the associated risks, the effects of electroconvulsive therapy are rather limited in time.The patient must continue with the medication after the intervention.

For which pathologies is it applied?

Electroconvulsive therapy is applied as a second-line treatment in certain psychological disorders such as depression, mania such as depression, mania and other mental illnesses in which medication is not effective, when the clinical picture is so severe or dangerous that drug therapy is not expected to have any effect, or in pregnant patients with a high risk of harm to the fetus.

This type of intervention has been shown to be effective in the treatment of the following disorders, causing a rapid and significant decrease in the most severe symptomatology.. It is usually used in the following cases.

1. Severe depression

ECT is particularly effective in cases of major depressive disorder, especially if it is characterized by psychotic symptoms. such as disconnection from reality or if suicidal thoughts are manifested.

2. Resistant depression

In this case it is used when the symptoms of severe depression are maintained over time regardless of the pharmacological treatments administered.

3. Severe mania

Within bipolar disorder, electroconvulsive therapy may be used when the patient is in the state of bipolar disorder. when the patient is in the state of intense euphoria typical of this disorder. of this disorder. This state is usually accompanied by impulsive behavior, drug use and psychosis.

4. Catatonia

Catatonia is distinguished by the loss of movement or the manifestation of accelerated and abnormal movements. Although in many occasions it is caused by an organic disease, it is usually related to schizophrenia and other psychiatric alterations of psychotic type.

5. Dementia

Electroconvulsive therapy may be common in patients with dementia who have high levels of nervousness and aggression. high levels of nervousness and aggressiveness.. These are resistant to treatment and decrease the patient's quality of life.

What is the procedure to follow?

Before starting electroshock therapy, the patient must undergo a thorough evaluation that includes the patient's medical history, a physical examination, psychiatric evaluation and physical tests, among which including blood tests, electrocardiogram and an anesthesiologist's report..

The purpose of these tests is to ensure that electroconvulsive therapy is safe for the patient, thus ensuring minimal risk or side effects.

Once the parameters or variables mentioned at the beginning of the article have been established, the treatment session is carried out. First of all, general anesthesia is administered and intravenous lines are placed to provide the patient with fluids and Anticonvulsant drugs.

Next, pads with the electrodes are placed on one or both sides of the head, depending on whether the current is to be administered by the electrodes or not.depending on whether the current is to be administered unilaterally or bilaterally. The session usually lasts between 5 and 10 minutes without taking into account the time the person needs to prepare and recover from the treatment.

At the end of the session, the patient is transferred to a recovery room where the patient is observed and monitored for any adverse reactions. It is common to experience feelings of confusion or disorientation upon awakening.

Finally, it is not necessary for the patient to be hospitalized, but in many cases it can be performed on an outpatient basis.

What are the results?

Although it is not yet known exactly how electroconvulsive therapy causes the brain changes that aid in the patient's recovery, the patient usually shows significant improvement after the sixth ECT session, although absolute remission may take much longer or even be impossible in some cases. or even impossible in some cases.

Because symptom improvement is usually temporary, the patient must often continue with drug treatment. the patient must often continue with pharmacological treatment or even require continuous electroconvulsive treatment.

What are the risks?

While the side effects or risks of electroconvulsive the side effects or risks of electroconvulsive therapy have greatly diminished since its creationHowever, we can still find some unwanted consequences that can be annoying or distressing for the person.

Among these side effects we find:

• Retrograde amnesia or memory loss of what happened moments before treatment or during the weeks of treatment.
• Sensation of temporary confusion.
• Headaches.
• Hypotension or hypertension.
• Tachycardia or heart problems.
• Muscle pain.
• Nausea.