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Ted Warnell

C O N T E N T S LIT Features, reviews, papers ELECTRO CONVULSIVE THERAPY Zn 99/03/12: After last week's Monica's Story... [ hey, not even one email of thanks for this ?!? ]... it is time at Zn to realign our thoughts to a cosmic oneness and higher awareness... universal truth and enlightenment with Poem by Nari... Copyright © 1999 by Zn and Poem by Nari. All rights reserved.

Electro Convulsive Therapy
POEM BY NARI
 
Electro Convulsive Therapy

  hizophrenia 3 themostcontroversialtreatm
  roduceageneralizedseizure2 treatmentfors
  istoryofabusec unfavorablemediapresentat
  ciallegalattentionf unevendistributionam
  everementalillness i e acutemania somesc
  ionsd compellingtestimonyofpatientse spe
  1 applicationofabriefelectricstimulustop
  ongpractitionersandfacilitiesg unevenacc
  entinpsychiatrya thenatureofECTitselfb h
  essbypatients

      rtheinstitutionalizedchronicallyill2 use
      swereunavailable ledtoaperceptionofECTas
      riouslyillinmentalinstitutionsb usedfora
      fectiveandevenharmfule usedasameansofman
      ychopharmacologicalmedicationsandwiththe
      hdosesandforlongperiodsoftimed ofteninef
      agingunrulypatientsforwhomothertreatment
      varietyofdisordersc frequentlygiveninhig
      anabusiveinstrumentofbehavioralcontrolfo
      ions3 nowusedmainlyingeneralhospitalpsyc
      developmentofjudicial regulatoryrestrict
      1 1940sand1950sa administeredtothemostse
      haswanedwiththeintroductionofeffectiveps
      hiatricunitsandinpsychiatrichospitals

      isn ttherepotentialformisuseandabuse 4
     1 isitbeingusedwhenalternativetreatmenti
     spossible 2 isittrulyeffectiveovertime 3
     uldcurtailingusedeprivecertainpatientsof
     isitsuseaviolationofpatients rights 5 wo
     potentiallyeffectivetreatment

  ousintheshortterm3 ECTastreatmentfordelu
  streatmentforendogenous melancholicdepre
  ortdurationofillness amoreacuteonset and
  erapidonsetofactionthanantidepressantsd
  ning2 ECTastreatmentfordepressiona themo
  entofdepressionb relapseratesarehighunle
  sionaldepressiona highlyeffectiveb super
  ectiveforthosepreviouslyunresponsivetoan
  italizationwithoutsomatictherapyc whenfo
  skofrelapse6 ECTastreatmentforschizophre
  tidepressantsc long termefficacyisunknow
  iortoantidepressantsorneurolepticsc effe
  n5 ECTastreatmentforacutemanicepisodea e
  llowedbylithiummaintenance noincreasedri
  noteffectiveformilddepressions i e dysth
  ymicoradjustmentdisorder e onlyadvantage
  ssiona effectiveshort termtreatmentb eff
  tshouldbetriedb effectiveforthosewithash
  notintermsofqualityoflifeorsocialfunctio
  ssmaintenanceantidepressantsareusedc mor
  ctiveforthosepreviouslyunresponsivetotre

  1 measuredonlyintermsofsymptomreduction
  steffectivetreatmentforshort termmanagem
  niaa neurolepticsarethefirsttreatmenttha
  atmentd long termefficacyisunknown4 ECTa
  quallyeffectiveaslithiumb superiortohosp
  moreintenseaffectivesymptoms

  feasible decreaseordiscontinuemedication
  ond EKGe laboratorytests2 whenclinically
  singECT19 requireperiodicinspectionofECT
  t4 evaluateandmonitorcardiacconditions5
  yplacingabloodpressurecuffonanarmorlegan
  lspecificallytrainedandcertifiedintheuse
  ndreviewcommitteesinhospitalsandcentersu
  aforECTadministrationandrecoverya haveap
  eb includeequipmentandmedicationstousein
  sthataffecttheseizurethresholdbeforebegi
  beforetreatmentb belithium free3 getseve
  rehypertensionundercontrolbeforetreatmen
  propriatehealthcareprofessionalsavailabl
  sethelowestamountofelectricalenergytoind
  ts12 rememberthatabriefpulsestimulusresu
  ltsinfewercognitivedeficitsthanthesinewa
  educatethepatientandfamilypriortoobtaini
  atnondominantunilateralECTresultsinshort
  erconfusionalperiodsandfewermemorydefici
  icalexaminations18 establishregulationsa
  1 performapretreatmentmedicalexamination
  ngwritteninformedconsent6 designateanare
  ofbriefanestheticprocedures8 includetrai
  nednursingpersonnelonthetreatmentteam9 u
  dinflatingitabovesystolicpressurepriorto
  tment continuepatientsonantidepressantme
  theeventofcomplications7 useaprofessiona
  dicationorlithium15 includeECTeducationi
  uceanadequateseizure10 rememberthatbilat
  eralECTisoftenmoreeffective11 rememberth
  nmedicalschoolcurricula16 includeECTtrai
  nningECTtreatmenta discontinueMAOI2weeks
  theinjectionofamusclerelaxer14 aftertrea
  ludequestionsaboutECTinoralandwrittenmed
  vestimulus13 monitorseizureswithanEEGorb
  a historyb physicalc neurologicexaminati
  ninginpsychiatricresidencyprograms17 inc
  equipment

          ure andpulseratethroughoutprocedure7 pla
          tilatoryassistancewithapositivepressureb
          withoneelectrodefrontatemporallyandthese
          ffasting2 giveatropineoranotheranticholi
          aperipheralveinuntilafterrecovery4 provi
          sareusuallyeffective9 theusualfrequencyi
          nergicagentpriortotreatment3 placeanIVin
          detheanestheticmethohexitalandthensuccin
          ylcholineformusclerelaxation5 provideven
          1 beginintheearlymorningafter8to12hourso
          cestimuluselectrodesbifrontotemporallyor
          agusing100 oxygen6 monitorEKG bloodpress
          condontheipsilateralside8 6to12treatment
          s3timesweeklyintheUS 2timesweeklyintheUK

        dividuals notforinstitutions7 foracutema
        eatment10 forseveredepressionorpsychosis
        sconsent1 risksandbenefitschangeinnature
        duringthe1sttrimesterofpregnancy11 after
        asbeenestablisheda delusionalandsevereen
        out4 whenabsolutelynecessarytopreserveli
        entions8 afterconsiderationofonesemotion
        apacitychangesduringtreatment3 ECTresult
        fthepossiblerisksandbenefitsinvolvedc wh
        asedintracranialpressureb space occupyin
        entifyandclarifytheoptionsthatthepatient
        procedured whenthephysicianhasstrovetoid
        dogenousdepressionsb acutemaniac certain
        schizophrenicsyndromes2 aftercomplexcons
        nicepisodecharacterizedbycertainsymptoms
        enthepatientunderstandsthecharacterofthe
        shavebeenfullyconsidered tested andruled
        lhistoryofunresponsivenessf personalhist
        1 onlyinthoseconditionsforwhichefficacyh
        fe5 whenthereisariskofsuicidenotmanageab
        lebyanyothermeans6 onlyforthebenefitofin
        individualcase3 afterallotheralternative
        oryofdebilitatingsideeffects12 whenthepa
        sinmemorylosssocontinuousconsentisessent
        medicalcomplicationse deaththroughexhaus
        alsufferingorextremeincapacitation9 when
        medicalconditionsprecludetheuseofothertr
        certainconditionshavebeenruledouta incre
        glesionsinthebrainc recenthistoryofmyoca
        iderationofadvantages disadvantagesinthe
        psychomotoragitationd highriskforserious
        treatmentoptionsb whenthepatientisawareo
        tionf nonresponsetopharmacologicalinterv
        rdialinfarctiond largeaneurysmse persona
        tienthasfreelygiveninformedconsenta when
        ialf acourtmustissueconsentforanincompet
        a cloudedsensoriumb dehydrationc extreme
        thepatientisawareofallothertreatment non
        aloneisentitledtoexercisee whenthephysic
        ianinitiatesperiodicreviewsofthepatient
        throughouttreatment2 thepatient smentalc
        entpatient

     andresultingmemorydeficits3 delineatethe
     ismsunderlyingthetherapeuticeffectsofECT
     nt5 identifypatientsubgroupsforwhomECTis
     1 anationalsurveya assemblethebasicfacts
     aboutECTuseb studypatientattitudesandres
     ponsestoECT2 identifythebiologicalmechan
     sandcognition4 determinethemodeofelectro
     long termeffectsofECTonaffectiveillnesse
     deplacementandstimulusparametersthatmaxi
     mizeefficacyandminimizecognitiveimpairme
     particularlybeneficialortoxic

ECT S15 41 1974
 
   
 
 
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