ECT Treatment: For or against it?

sgent · Jul 18, 2005

One of the first things to realize is that today's ECT is nothing like it was 60 years ago. The reality that brought us "One Flew Over the Cukoo's Nest" and other popular images of ECT, is long past. That method of ECT has as much to do with modern medicine as an amputation done w/o anesthesia or painkillers in the civil war.

The reality is that ECT is a safe and extraordianrily effective method to control acute symptoms of psychiatric illness. As to the protocol, I'm not sure of the number of treatments usually undergone; however, serveral are usually presribed. ECT is done is a state of anesthesia, with monitoring. The most common side effect is that of short term memory loss.

As for you personally, I think its a decision you have to make with your doctor. Although the side effects exist, they may turn out to be minor in comparison to the damage that a long term psyciatric problem can cause.

elkpark · Jul 18, 2005

I agree with sgent. I've been a psych nurse for ~20 years now, and have seen ECT help an awful lot of people who were not helped by other treatments. I would choose to take it, myself, over a lot of the psych medicaitons that are given these days ... It is generally safe and effective (in fact, the results can appear near-miraculous) for the problems for which it is used these days (the "rules" are v. strict).

Treatments are generally given every other day (M-W-F or T-Th-S) and the length of the program depends on the client's response (12-15 txs would not be unusual/excessive). Most facilities use quick general anesthesia, so the client has no awareness at all of the treatment itself (frankly, the anesthesia is a greater risk/danger to you than the ECT ...) Treatment can be "unipolar" (one side of the head) or "bipolar" (both sides of the head). I have heard that the (minimal) side effects are less likely with unipolar treatment but the therapeutic effect may not be as strong/long-lasting, but I don't know any solid info about that.

I know that there are older threads here that talk about ECT (I know I've posted on ECT here before) -- you could search and review those for more info/opinions.

Best wishes --

leslie :-D · Jul 18, 2005

one time i had a patient that was so depressed that she stopped talking, eating (needed g-tube), ambulating with the flattest of affects.

after trying every available pharmocological regimen, her son authorized ect for her, per the recommendation of her doctor.

after a few treatments, this woman was walking, smiling (!!) eating, conversing and had a song in her voice. it was like watching a living miracle.

then her dtr found out she had been receiving these treatments (she lived out of state) and stopped them immediately. she didn't see or care about the drastic improvement of her mother but was fixed on ect being a barbaric treatment. so all treatments were stopped and she went back to her catatonic mode. so, so sad.

do your research and as already stated, it's nothing as it was 50 yrs ago. much luck to you.

wishing you peace,

leslie

lpnstudentin2010, LPN · Jul 18, 2005

i am for it. a friend of mying has bipolar and did not respond to ANYTHING but shock therapy has helped

Haunted · Jul 19, 2005

I have worked for several years with a facility in Costa Mesa that performs out patiant ECT. It is a gentle procedure, the patient's are usually fully recovered and walking out of the facility within a few hours.

I have seen severely depressed ( poor hygiene, poor eye contact, frown, crying, verbalized despair and just an overall heavy and sad demeanor) improve to happy, smiling and productive people in a matter of weeks. No specific treatment is "right" for everyone but I have seen it work, so I am FOR IT!!!! Sorry Tom Cruise!

suzy253, RN · Jul 19, 2005

Definitely for it. Got to observe the treatment during psych rotation and see the difference it makes in some patients before and after.

suzanne4, RN · Jul 19, 2005

Thumbs up to it, especially after you have seen the results.

Keely-FutureRN · Jul 19, 2005

Thank you for all your responses. I don't want to label ECT as automatically not an option. I too have friends who have had ECT and have done a complete 360 in their attitude and demenor. I guess it's just a little different when you are considering it for yourself. Thanks again. :icon_hug:

Keely

CharlieRN · Jul 19, 2005

I have to tell you my story.

At my first psych nurse job I was assigned to work out the ECT protocols for our new unit. Probably because I fresh out of the ER and more familiar with "medical " nursing. I was appalled that we were using this barbaric technique frrom the dark ages. ... Then I went and watched the procedures. The treatments were done in the OR suite with an anesthesologist in attendence. The pt was under full anesthesia, the shock takes maybe 20 sec and the only physical evicence of it is a slight curling of the toes. The next hour or two the patient spent recoveing from anesthesia. We started at 8am and the patients were fully recovered and up to eat lunch.

We used ECT primarily to treat elderly depressives who it was felt could not tolerate the cardiotoxicity of the anit depressants in use then. As a treatment for depression it is hard to beat. There is going to be at least some memory loss. Modern advances keep that to a minimum. My current employer does ECT on an out pt basis. I think the usual couse of tx is 6 to 12 episodes over a two week to a month period.

Were I severely depressed it is the treatment I would prefer.

Whispera, MSN, RN · Jul 20, 2005

I've been a psych nurse for 15 years. I've seen miracles brought around by ECTs. Many miracles. I think for the most part, I'm in favor of them.

However, I don't want people to think they're always wonderful. I worked with a nurse who had ECTs to treat her disorder. She had a long series of them. After she was finished, she never regained all of her memory. In fact, she wasn't able to be effective at work anymore, because she forgot much of what she had learned in nursing school.

So, I wouldn't recommend them unhesitatingly.

CHATSDALE · Feb 19, 2007

i have seen residents at our facility and when they became unruly and unable to respond to a chg in meds and they were sent to a facility who did these along with med consult

it seemed like that this was very effective on the first visit and it frequently lasted for 2-3 years ]however not all achieved good effect for that length of time] on subsequent tx the side effects were more pronounced and did not subside

however these patients required 24/7 care on their best days, this might be a factor but it did make the residents less aggressive