Electroconvulsive therapy (ECT)-

The therapy was developed by Cerletti and Bini in 1933. It is believed that epilepsy and schizophrenia do not coexist in a single patient and that artificial convulsion is beneficial for improving mental health.

To induce a convulsion, chemicals such as flu vaccines are inhaled or injected intravenously.

Previously, there was uncertainty about when the convulsions would begin and how long they would last.

There are three methods –

Temporal method
Frontal method
Unilateral ECT

1. Temporal method –

Nowadays, each electrode is placed on the temporal aspect and an electric current is passed through it.
The voltage of the current is 90 to 110 V. The duration is 0.1 to 0.9 seconds.
It was further noted that below 90 V, the patient does not have the required amount of convulsion and above 110 V, there is damage or danger to the brain and no further clinical improvement is seen.
The goal is to generate a current in the minimum vault in the shortest amount of time.

2. Frontal method –

Both electrodes are placed in the frontal region.
Frontal placement can cause damage to the forehead bones, resulting in cosmetic problems.

3. Unilateral ECT –

In this, a single electrode is used on the non-dominant hemisphere of the brain.
Duration and volt are the same.

Advantages of ECT–

Reduces memory impairment.

The procedure of ECT –

The first step – a patient should be on an empty stomach and consultation should be taken with family members.
Second step – The ECT is given in a supine position when the patient is tied up on the plinth.
Third step – a piece of rubber is kept in the mouth and a current is given.
Fourth step – After this treatment, the pulse rate, respiration rate, and BP are checked and anxiety-reducing medicine is given.
The treatment may be given on alternate days.

The course of ECT –

6 to 10 minutes, twice or thrice a week.

Indications –

Schizophrenia
Depression
Manya
Postpartum psychosis
Paranoid state
Hypochondriasis

Contraindications –

It is not used in a space-occupying lesion that is present in brain-like tumours.
Bleeding peptic ulcers.
Recent myocardial infarct:
Severe chest disorders.