ECT Defined correct answers §Electroconvulsive therapy (ECT) is the induction of a grand mal (generalized) seizure through the application of electrical current to the brain.
§ECT has long had a negative reputation.
§One of the most controversial treatments for psychological disorders
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Nursing 316 Exam 2 Chapter 20
Electroconvulsive Therapy
ECT Defined correct answers §Electroconvulsive therapy (ECT) is the induction of a
grand mal (generalized) seizure through the application of electrical current to the brain.
§ECT has long had a negative reputation.
§One of the most controversial treatments for psychological disorders
§Despite its controversial image, ECT has been used continuously for more than 50
years.
§With ECT, seizure is induced by administering a dose of electrical current through
electrodes placed either bilaterally or unilaterally.
•Right unilateral ECT is associated with fewer cognitive side effects.
•The dose of electrical current is carefully controlled through the use of an ECT
machine.
•Amount of electrical stimulus applied is controversial
•A patient's seizure threshold may increase 25 to 200 percent during the course of ECT
treatments.
•ECT itself acts as an anticonvulsant, because the seizure threshold increases as
treatment progresses.
•Movements are minimal because of the administration of a muscle relaxant before
treatment.
‒Tonic phase
‒Clonic phase
•Most require 6-12 treatments; some require up to 20.
•Treatments administered every other day—3 times per week.
Tonic phase correct answers The tonic phase of the seizure usually lasts 10 to 15
seconds and may be identified by a rigid plantar extension of the feet.
Clonic phase correct answers The clonic phase follows and is usually characterized by
rhythmic movements of the muscles that decrease in frequency and finally disappear.
Because of the muscle relaxant, movements may be observed merely as a rhythmic
twitching of the toes.
, ECT notes correct answers -The induction of a grand mal (generalized) seizure through
the application of electrical current to the brain.
-One of the most recent debates stems from the FDA's (2015) proposed rule that
categorizes ECT machines as low-risk, a downgrade from their long-held high-risk
classification. Critics of the procedure take offense to this proposal, with some even
threatening to sue the FDA.
-Despite its controversial image, ECT has been used continuously for more than 50
years, longer than any other physical treatment for mental illness. It has achieved this
longevity because when administered properly, for the right illness, it can help as much
as or more than any other treatment.
-With ECT, seizure is induced by administering a dose of electrical current through
electrodes placed either bilaterally (in the bifrontal or bifrontotemporal area) or
unilaterally on the right side of the frontotemporal area.
-Right unilateral ECT is associated with fewer cognitive side effects, and its efficacy can
be ensured with adequate dosing strategies.
-While unilateral treatments were once conducted on the hemisphere of the non-
dominant hand, Sadock and associates note that the right hemisphere is involved in
sustaining depressed mood regardless of handedness.
-The dose of electrical current is carefully controlled through the use of an ECT
machine.
-The dose of electrical stimulation must be strong enough to reach the patient's seizure
threshold, but this threshold is highly variable among individuals. Observing the patient
for seizure activity is not always the best indicator.
-The tonic phase of the seizure usually lasts 10 to 15 seconds and may be identified by
a rigid plantar extension of the feet.
-The clonic phase follows and is usually characterized by rhythmic movements of the
muscles that decrease in frequency and final
Historical Perspectives correct answers §First treatment performed in 1938 in Rome
§Other types of somatic therapies tried
•Insulin coma therapy
‒Introduced by German psychiatrist Manfred Sakel in 1933
•Pharmacoconvulsive therapy
Introduced in Budapest in 1934 by Ladislas Meduna
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