Electroconvulsive Therapy (ECT) Part 1 [Introduction to ECT] History of ECT

Electroconvulsive Therapy (ECT) Part 1 [Shock treatment] History of ECT

Electroconvulsive therapy (ECT) is a form of psychiatric treatment that involves inducing seizures with the use of electrical stimulation while an individual is under general anesthesia.

ECT is primarily indicated in people who require a rapid treatment response due to the severity of their condition such as violent patients or risk for suicide or catatonia.

History of ECT

Electroconvulsive therapy (ECT), is one of the oldest and most controversial treatments in the field of psychiatry. Convulsive therapy was introduced by Dr Laszló Meduna. He observed that seizures and psychosis do not co-exist. Whenever, psychosis patient had seizure behavioural problems vanished. Hence, Meduna planned to induce a seizure using a chemical agent and proceeded to test the safety and effectiveness of several epileptogenic compounds for this purpose. Finally, Meduna identified camphor as the compound that satisfied his requirements. Although camphor was later replaced with intravenous cardiazol, chemical seizure induction remained somewhat unpredictable, with considerable interpersonal variance.

The idea of using electricity to induce seizure first occurred to Cerletti and Bini when they witnessed cardiazol therapy in Vienna. Ugo Cerletti and Lucio Bini used an electric current to elicit an epileptic seizure for therapeutic purposes. They performed the first electric seizure induction in a psychotic patient named Enrico X on April 11, 1938.

ECT may offer a number of important benefits, including:

Fast-acting: ECT usually works very quickly to relieve symptoms of psychiatric conditions. This can be particularly helpful in cases where a person is experiencing severe symptoms.

Effectiveness: ECT has shown a high level of efficacy in the treatment of some conditions. It can be particularly beneficial to people with severe depression, psychosis, and suicidal thoughts and behaviors.

There are two types of ECT:

Bilateral ECT, in which the electrodes are placed on both sides of the head. This is designed to affect the entire brain.

Unilateral ECT, in which one electrode is placed on top of the head and the other on one temple, usually the right. In this case, the current only passes through one side of the brain.

The introduction of convulsive therapy to psychiatry and changes in seizure induction from chemical to electrical are outlined. The place of ECT in contemporary psychiatry, particularly its most important clinical indications, is briefly discussed. Negative media representation and historical misuse are likely to have contributed to negative professional and public attitudes towards ECT

ECT is probably the most controversial form of treatment in medicine. It has been banned in certain parts of the world while remaining widely practiced in other countries. In the last two decades several new neurostimulation methods have been introduced in psychiatry mainly from the field of neurology. These include transcranial magnetic stimulation (TMS), vagus nerve stimulation, deep brain stimulation, transcranial direct current stimulation. Most of these new techniques were introduced to treat major depression