Who has given ect before?

[FreudsDaddy]

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I was wondering what you guys think of it. Like how serious is the memory loss and is it really painless? and any other side effects and the seriousness of them.

 

[Doc Samson]

I was wondering what you guys think of it. Like how serious is the memory loss and is it really painless? and any other side effects and the seriousness of them.

Extremely effective for treatment resistant mood DOs/psychosis, and really the best treatment for catatonia (whether due to a primary psychiatric illness or a medical etiology). Memory loss tends to effect memory 6 weeks either side of the treatment, but is variable from pt to pt. The other side effects I've seen are mostly due to the anesthesia (bradycardia, hypotension, etc.).

 

[OldPsychDoc]

Agree with Doc S. Would add re: "painlessness" that a lot of patients have myalgias and headaches afterward secondary to the anesthesia, the succinylcholine, and/or the jaw clenching. Usually can be well-managed symptomatically.

 

[stat3113]

I think most of the public's exposure to ECT is from the media, where its portrayed as being used in totalitarian states as a form of torture in government "hospitals", etc.

Is ECT always given with the patient's consent in the US? Under what circumstances, is it given involuntarily?

 

[Doc Samson]

I think most of the public's exposure to ECT is from the media, where its portrayed as being used in totalitarian states as a form of torture in government "hospitals", etc.

Is ECT always given with the patient's consent in the US? Under what circumstances, is it given involuntarily?

Fairly rarely... in cases of immediate medical need (e.g. malignant catatonia) or when the pt is absolutely unable to give consent and a substituted decision maker gives consent instead. In cases where no substituted decision maker (i.e. next-of-kin) is available, it is excrutiatingly difficult to have the courts give an appointed guardian authority to consent for ECT for primary psychiatric illness (somewhat less difficult for catatonia 2/2 a medical etiology).