Shock "Treatment"

On March 25 of this year, Psychiatric Times published an article titled Dementia, Agitation, and Aggression: The Role of Electroconvulsive Therapy. The author is Manjola Ujkaj, MD PhD, and the article’s subtitle is “What role might electroconvulsive therapy play for short-term treatment of agitation and aggression in patients with dementia?” According to their website Psychiatric Times is a medical trade publication that covers news, reports, and clinical content related to psychiatry “for psychiatrists and allied mental health professionals who treat mental disorders.” The circulation of the monthly print publication is approximately 40,000. ...

On May 16, 2014, the International Journal of Geriatric Psychiatry published an article by Deepa Archarya, PhD, et al. The article is titled Safety and utility of acute electroconvulsive therapy for agitation and aggression in dementia. Here are the authors’ conclusions: "Electroconvulsive therapy may be a safe treatment option to reduce symptoms of agitation and aggression in patients with dementia whose behaviors are refractory to medication management." In their Introduction section, the authors write: "Despite the high prevalence of these agitated and aggressive behaviors, there are currently no treatment options approved by US Food and Drug Administration for this indication. Nonpharmacological interventions, including environmental and behavioral modification, are difficult to implement in nursing home settings because of low staff-to-resident ratios." ...

There’s an interesting article in the June 2014 issue of the Journal of ECT. It’s written by Max Fink, MD, and is titled Celebrating 80 Years of Inducing Brain Seizures as Psychiatric Treatment. Dr. Fink is a psychiatrist and neurologist, and professor emeritus of psychiatry and neurology at the State University of New York, Stony Brook. The article is short (approximately 400 words), and is essentially a tribute to Ladislas Meduna for his discovery “…that induced seizures alleviated severe psychiatric disorders…”, which Dr. Fink describes as “…a remarkable medical advance…” ...

TMS is a psychiatric treatment that uses a rapidly alternating magnetic field to induce electric currents in the brain. These currents stimulate neurons, causing them to “fire.” When used repetitively, TMS is said to alter the excitability of the brain area that has been stimulated. In the psychiatric field, TMS is being used increasingly as a treatment for depression, particularly with so-called treatment-resistant clients. I Googled the string “TMS + depression” and got 1.35 million hits. So the idea is attracting attention. ...

ECT, or shock treatment as it’s sometimes called, is a controversial topic. Adherents describe it as safe and effective; opponents condemn its use as damaging and ineffective. But it is still widely used in the US and in other countries. The treatment consists essentially of passing sufficient electricity across the brain to cause a seizure. Clients are anesthetized during the process. It is used primarily in cases of severe depression. Typically, shock treatment is administered twice a week until the depression remits or until no further improvement is noted in two successive sessions. Most courses of treatment involve about eight sessions. ...

There’s a new article on Frontiers in Psychiatry. It’s titled Electroconvulsive treatment: hypotheses about mechanisms of action. The authors are Roar Fosse, Division of Mental Health and Addiction, Vestro Viken State Hospital Trust, Lier, Norway, and John Read, Institute of Psychology, Health, and Society, University of Liverpool, UK. Thanks to Mick Bramham on Twitter for the link. The authors reviewed a large number of human studies in which the brains of people receiving shock treatment were observed using EEG, PET, SPECT, and fMRI. ...

Last Monday (August 26), Lauren Spiro published a post on Mad in America. The post is titled The Today Show and ECT: The Full Story & Informed Consent. Here’s the gist of Lauren’s article. On August 20, the Today Show ran a segment on ECT (electric shock “treatment”). Lauren contends that the coverage was not balanced, but was pitched heavily in favor of shock “treatment.” Lauren provides a link to the segment, and also a transcript. I have watched the video, and read the transcript, and I agree that the coverage was very much pro-ECT, and that side effects were trivialized. ...

I’ve recently come across (courtesy of Tallaght Trialogue on Twitter) an article titled: The Court: Electroshock treatments should not be forced on psychiatric patients. The original was in Israel Hayom, an Israeli newspaper, and was written by Edna Adato. The English version above was on occupypsychiatry.net, and was translated by Janna Weiss. The article is brief, and the content is straightforward. As a result of a recent Israeli court ruling, electric shock treatment will not be administered against a person’s will, even if the person has been involuntarily committed to a mental hospital. ...

BACKGROUND At the APA annual convention in San Francisco in May of this year, Chad Puffer, DO, of the Mayo Clinic, presented a poster display titled ECT Use in Adolescents at the Mayo Clinic. The poster was reported by Caroline Cassels of Medscape.com, a month later (ECT in Kids: Safe, Effective, Robust and …Underutilized), and drew critical comment a week later (July 2) from Kelly Patricia O’Meara of CCHR International. I didn’t spot any of this until last week, when it came up on the Twitter feed from DxRevision Watch and Peter Kinderman. ...

Courtesy of Talla Trialogue on Twitter, I recently read an article in journal.ie on this topic. Kathleen Lynch, Minister of State for Disability, Equality, Mental Health and Older People, has reportedly stated that “…the law will be changed so that unwilling patients will no longer be forced to receive ECT.” At present, if an individual refuses ECT, his refusal can be overridden by the signatures of two psychiatrists. However, not everyone is in favor of the ban on forced ECT. There’s an article by Marie Feely, Proposed ban on Involuntary ECT criticized published in irishmedicalnews in January 2012. The article reports on a survey of consultant psychiatrists published in December 2011. Ms. Feely writes: ...