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ECT

What is ECT?

Electro Convulsive Therapy (ECT) is a proven and effective treatment method used by psychiatrists to treat psychiatric problems like depression.

ECT stimulates the brain so that essential neurotransmitters like serotonin and nor-adrenaline are produced and secreted by the brain to normalise mood and other brain functions.


Indications

ECT is recommended for:

      • Severe depression which does not respond positively to medication and other treatment modalities like psychotherapy.
      • ECT is more effective in the “biological”/endogenous type of depression that is caused by physiological disturbances in the brain. That is where there is a significant depletion of neurotransmitters like serotonin and nor-adrenaline.
      • When depression is life threatening, ECT is recommended.
      • It is also recommended for some other psychiatric illnesses like schizophrenia.


ECT procedure

A series of six to twelve ECT treatments are generally recommended. ECT is usually done three times a week on Mondays, Wednesdays and Fridays.

ECT is performed in a theatre under general anaesthetic by an anaesthetist. A muscle relaxant, Scoline, is administered during the anaesthetic. This makes the procedure safe and more comfortable for the patient. A continuous supply of oxygen is given. A heart monitor monitors the heart action, a BP cuff around the arm monitors the blood pressure and an oxygen monitor is put on the finger. The psychiatrist applies an electrical stimulus with two electrodes that are held against the temples. This induces a convulsion. Due to the muscle relaxant, the convulsion is very mild.

The convulsion has a beneficial effect because a large amount of necessary neurotransmitters are secreted by the brain. It is the increase in neurotransmitter concentration that helps to improve the mood or other disorder.

The procedure is very short and the anaesthetic lasts for about five minutes. Afterwards the patient is taken on a bed to the recovery room where he/she is monitored and given a chance to wake up properly.


The effect of ECT

As the course of ECT treatment progresses, a gradual improvement in mood will be noticed.

Together with this, there is improvement in motivation, positive thinking and the ability to manage the demands of life. ECT improves the feeling of helplessness that depression causes.

However, ECT is not a permanent cure. Relapse is unfortunately possible, and one should still continue with medication.


Side-effects of ECT

The most significant side effect is short term memory loss. That may last for a few days or weeks, up to a maximum of six months. Short term memory problems are experienced differently by different people. Some people have few problems with memory, whereas others find it more disruptive. The best advice is to have a positive attitude, be aware that you may forget some things and keep record if you have to. The memory problems concern things happening around the time of ECT. Long term memory is rarely affected.

Other side effects are headaches, muscle ache and short periods of confusion. This usually lasts only for a short while after ECT. Preparations for ECT

      • Discuss all your queries and fears with the psychiatric professional nurse or psychiatrists.
      • Sign consent for anaesthetic and ECT procedure in advance.
      • Do not have anything to eat, drink or smoke from 22:00 the evening before ECT.
      • Remove all jewellery and nail varnish.
      • Empty your bladder before treatment.
      • Wear comfortable clothing, preferably trousers.


Hints for after treatment

        • Try to sleep a while and be calm after each treatment.
        • You may ask for pain medication if you have a headache.
        • Do not make important decisions while you are having treatment.
        • Do not drive within the first 24 hours after anaesthetic.
        • Use only prescribed medication.


Costs

        • Treatment at Vista Clinic is according to the scale of benefits determined by medical schemes and managed by healthcare organizations.
        • As each medical scheme determines their own benefits, it may be necessary for a co-payment in some instances.
        • The accounts of the psychiatrist and anaesthetist are separate from Vista Clinic’s account.

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