Electroconvulsive and Neuromodulation Therapies by Conrad M. Swartz MD

By Conrad M. Swartz MD

Electroconvlusive treatment (ECT) is a psychiatric remedy regarding the induction of a seizure in the course of the transmission of electrical energy into the mind. within the early eighties, ECT was once changed through way more powerful psychopharmacologic drugs as a main remedy modality. a lot of the decline in use of ECT at the moment used to be additionally ascribable to the variety of problems linked to the approach. due to fresh refinements and a stronger figuring out of the clinical mechanisms underpinning ECT, this remedy modality has in recent times visible a resurgence in use in medical perform. This publication is the hot definitive reference on electroconvulsive and neuromodulation remedy. It comprehensively covers either the medical foundation and medical perform of ECT, in addition to offering readers with administrative views for the educational and administration of this modality in medical perform. The more recent different types of non-convulsive electric and magnetic mind stimulation treatment also are lined intimately and awarded as a separate part.

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All commercially available modern stimulus generators supply a constant (and therefore limited) current. This means that voltage increases with impedance because current remains fixed. This is generally safer than constant voltage because of the possibility of a short circuit between the electrodes (as from sweat, gel, water, or if electrodes are too near each other). With constant current, a short circuit produces impedance near zero and thereby a voltage near zero. No burn can occur because the rate of energy release is low, as it equals impedance times current squared.

R. 1986. Effects of stimulus parameters on cognitive side effects. Ann NY Acad Sci 462: 315–25. West, L. , Pierce, C. , and Thomas W. D. 1962. Lysergic acid diethylamide: Its effects on a male Asiatic elephant. Science 138: 1100–2. 2 Nonelectrical convulsive therapies Niall McCrae Introduction This chapter reviews nonelectrical convulsive therapy (non-ECT) procedures, including pentylenetetrazol (PTZ) and cyclohexylethyltriazol, flurothyl inhalation, and insulin coma therapy, which also had epileptoid effects.

Et al. 1987. Effects of electrode placement on the efficacy of titrated, low dosage ECT. Am J Psychiatry 144: 1449–55. Sackeim, H. , et al. 1994. Physical properties and quantification of the ECT stimulus: I. Basic principles. Convuls Ther 10: 93–123. Sackeim, H. , et al. 2008. Effects of pulse width and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Brain Stimulation 1: 71–83. Swartz, C. M. 1989. Safety and ECT stimulus electrodes: I. Heat liberation at the electrode-to-skin interface.

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