[Redway]

Originally Posted by Twosugars

Will it not confuse anybody if melancholia stands for severe psychotic depressions?

Give us a good intro, Redway: technique/preparation, uses, side-effects plus anything extra you consider useful.

Spoiler:

• Indications: psychotic depression (especially bipolar), acute episodes of schizophrenia, autism (apparently) and Parkinson’s disease. As a side they reckon that ECT isn’t used nearly enough with end-stage Parkinson’s patients.
  
• There’s some evidence it works for people with the DTs.
  
• No one knows exactly how it works but there’s got to be an electrical seizure going on upstairs for it to work. The bad motor reactions can be averted by a med called succinylcholine with the same therapeutic effect.
  
• Every candidate for ECT is given: an electrocardiogram, chem survey and CBC. Medications which make the post-ECT confusion worse (lithium and the tricyclics) are put on hold at this point.

Technique:

• Scalp gets cleaned at night where electrodes (main ECT ingredient) will be placed the next morning
  
• Dentures are taken out
  
• ECT can be either uni-or-bilateral. The charges according to seizure threshold for the patient vary from 50% over (light) to 500% over (deep). It’s always parallel to how severe/life-threatening the case is. Most docs opt for unilateral at moderate charge.
  
• Usual surgery stuff’s done after that point – ECG machines/heart monitor, all that.
  
• The patient’s always oxygenated with 100% oxygen (administered through a few mask).
  
• The seizures aren’t meant to last more than 30 seconds to one minute.

• Treatments given x3 per week—most people need 6 to 12 treatments (in other words up to a month of ECT) for it to work in full. First response usually seen after the third treatment.
  
• Since muscle relaxants were introduced fractures are super rare. ECT’s no more risky than any other major surgery.
  
• The amnesia people mention only happens to some people and doesn’t usually extend to the events a week before ECT until after the last treatment.
  
• Outside the treatment timeframe memory’s perfectly clear.
  
• ECT’s been known to cause mania in bipolar depressed people.
  
• Someone closer the top of this thread said that ECT doesn’t alter the natural course of the illness and that it just suppress symptoms. That’s true but there’s people that depressed that the ECT saved them in the same way that Lazarus resurrected from the dead. It brings people out of the danger zone.
  
• Maintenance ECT is sometimes given to people who relapse—about one treatment a week for 2 months and then tapered down.

Summarised as much as I could. Holla if you've still got questions though.