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Chapter 27. Electroconvulsive Therapy

Richard D. Weiner, M.D., Ph.D.; Andrew D. Krystal, M.D., M.S.
DOI: 10.1176/appi.books.9781585623754.397112

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Excerpt

Electroconvulsive therapy (ECT) involves the electrical induction of a series of seizures as a treatment for mental disorders, most notably major depression. This chapter covers the history of ECT; the extent to which it is used; indications; risks; the evaluation of patients for ECT; ECT technique; the use of ECT to alleviate episodes of illness (index ECT); management of patients after completion of the ECT course, including the use of ECT to prevent relapse (maintenance ECT); and a brief discussion of what can be expected in the future of this treatment modality. Throughout the chapter, a particular focus is placed on the use of ECT in the elderly. With the mean age of individuals referred for ECT increasing, the importance of ECT in geriatric psychiatry continues to grow.

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Sample questions:
1.
Electroconvulsive therapy (ECT) has been demonstrated to have efficacy in testing a number of specific conditions or disorders. For which of the following has ECT not been shown to be efficacious?
2.
ECT is a highly effective treatment for a number of neuropsychiatric conditions; however, some patients who receive ECT for depression will relapse within 1 year after treatment with ECT, even when treated with typical continuation or maintenance pharmacotherapy. What is the estimated relapse rate for depressed patients 1 year after ECT treatment and when continued on pharmacotherapy?
3.
Pharmacotherapy is usually indicated after a successful course of ECT unless one of certain specific conditions exists. All of the following are examples of these contraindicating conditions except
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