ECT for Treatment-Resistant Depression
ECT Can Help Depression
Patients who suffer from treatment-resistant depression should no longer look at electroconvulsive therapy (ECT), formerly known as electroshock therapy, as a last resort for treatment. Professor of Psychiatry and Chief of the Division of Geriatric Psychiatry at the Mount Sinai School of Medicine, Charles Kellner, M.D. states that seriously depressed patients who have not responded to medication trials benefit from modern ECT therapy, especially geriatric patients.
Modern ECT is tolerated much better than it was decades ago, as advances in ECT techniques have made it so. The cognitive side effects that patients used to experience are much more minor now. Advances in right unilateral electrode placement and ultra-brief pulse stimulus wave forms have reduced the memory impairment that was bothersome in ECT’s early stages. According to Kellner, many patients have minimal memory impairment, but they feel that it is an acceptable side-effect to having their major depression lifted.
Are there side effects to ECT?
“Typically, patients have some decreased memory for the several weeks around the course of the ECT treatment, but often times, it is very little more than that,” stated Kellner in a video regarding ECT posted on PsychiatricTimes.com.
Memory issues should no longer be a reason that patients are not referred to ECT clinics. Patients who need to feel better quickly should look at ECT as a more acceptable treatment. According to Kellner, there are patients who remain seriously depressed for too long before ECT treatment is sought. Even one to two years of failed medication trials is too long.
Today, ECT is tolerated so well, that it is often done on an outpatient basis. In fact, more that 50 percent of ECT therapy in the United States is completed in outpatient facilities. It is available at over 500 inpatient facilities and many more outpatient facilities around the country, with most large medical centers offering it as a treatment for depression.
ECT is an Outpatient Procedure Now
Going through the treatment is similar to having a minor outpatient surgical procedure done. ECT is completed under full general anesthesia so that the patient is completely relaxed during the process. Doctors are able to give patients medicine during the procedure that helps to decrease headaches and nausea that may be caused by the brain stimulation. Also, doctors are able to control the patient’s heart rate and blood pressure during the procedure using fast-acting intravenous medicines. The procedure is extremely safe.
While depressed patients of all kinds can benefit from ECT, this treatment is especially perfect for geriatric patients. Often times, the elderly are not able to handle the side effects of antidepressants, and overall, antidepressants are known to not work as well in this population.
“For geriatric patients, ECT should be a serious treatment consideration,” stated Kellner.
The elderly will not suffer from severe depression with ECT as they would jumping from medicine to medicine looking for a good fit—as they may never find one.