What is Electroconvulsive Therapy and How Does it Work?
Electroconvulsive therapy (ECT, also called electroshock therapy) is the practice of purposefully causing seizures to give relief from or reverse a wide range of psychological symptoms. Modern ECT is safe though it is still normally used as a last resort because there can be cognitive side effects. There are a few different theories as to why ECT works, two that are notable, one proposes that the seizure causes a change in neurotransmitter activity, the second is that the seizure alters the regulation of stress hormones. There are two methods of administering ECT, right unilateral and bilateral. Right unilateral (right image) placement has one electrode placed upon the right temple and another on top of the head and has the least risk of the two. Bilateral (middle) includes placement of the electrodes on both temples of the head and has a lower charge. ECT is mainly used to treat cases of severe anxiety or depression that haven't responded to medicine at all, but is also used to treat schizophrenia, mania and the sort.
Early Electroconvulsive Therapy
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Modern Electroconvulsive Therapy |
The first time People experimented with ECT was in 1937. Ugo Cerletti used ECT in 1937 when he tried to treat a patient with Schizophrenia. He found out that the shocks also gave people a type of Amnesia where they wouldn't remember the therapy ever happening. ECT began to be publicly advertised in 1939. Lother Kalinowsky traveled to the U.S and Multiple countries in Europe to show doctors the invention. It was huge when it showed a 90% success with patients. ECT has been greatly improved over the years. Comparing Early ECT and Modern ECT will show many differences.
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Research is constantly being done with ECT. John Hopkins has done multiple studies with a new technique using "ultra-brief" pulses at 0.3 milliseconds, rather than the normal-length pulses at 1.5 milliseconds. The same charges were used for both placements, right unilateral was charged to 6 times the seizure threshold, bilateral was charged to 2.5 times. The ultra-brief pulses were found to be just as effective at causing a seizure, but, with significantly decreased chances of cognitive side effects, including faster orientation after the seizure. Modern techniques also include anesthesia to prevent broken bones and memory loss and is more controlled than the older techniques. A manuscript of the John-Hopkins study can be found here and a comparison of the techniques can be found here.
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