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ECT More Effective Than Anti-depressants, Says Australian Expert

by Medindia Content Team on Apr 15 2008 12:28 PM

Some might frown on electro-convulsive therapy (ECT), but an Australian expert asserts it is one of the most effective treatments for psychotic depression. And any day more effective than anti-depressants.

The ECT, also known as electric shock treatment, despite its bad reputation, has been clinically shown to be effective in treating a variety of mental disorders, particularly depressive illness, says Dr Ashar Khan, a consultant psychiatrist at the Health Sciences and Medicine faculty of the Bond University, Queensland.

“Where there are imminent risk issues to either the patient or their immediate family, ECT achieves an 80 per cent plus success rate and is the most appropriate treatment to move the patient out of that critical phase,” he is convinced.

While the therapy is often considered as a ‘last resort’ treatment for depressed patients who don’t respond to anti-depressant medications or are intolerant to the side effects, Dr.Khan argues that actually ECT-administered patients recover faster and their recovery is absolute too.

In severe post-partum psychosis, for instance, ECT would likely be the most effective treatment option.

“Depression and psychosis in a woman who’s just given birth is usually very severe, sometimes to the extent where she has suicidal tendencies. The wellbeing of both the mother and the child is in jeopardy.

“Research tells us any breakdown of early maternal bonding has ongoing consequences in the cognitive, developmental and emotional growth of the child - particularly in the first few weeks post-birth.

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“In this case, the patient does not have the luxury of time to trial different anti-depressant medications that may, or may not, eventually work.

“If the treating clinician wants mother to have her quality of life back sooner and have a better impact on the child and family, then ECT ought to be considered,” he insists, according to a press release put out by the Bond University.

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“ECT still has a bad reputation, due in no small part to the sensationalism created by the media and entertainment industry – take for instance, Jack Nicholson in One Flew Over the Cuckoo’s Nest.

“These graphic images of people shaking and foaming at the mouth, or the idea of ECT as a behaviour control torture method, are still embedded in the community and we need to undo these stigmas.

“In the past, around 40 years ago, there was a lack of guidelines worldwide so people were being given ECT without any real clinical consensus on what was good practice.

“Now days, we have a clear set of standards and guidelines. ECT is also now the only treatment for depression that requires the involvement of multiple disciplines – an anaesthetist, theatre staff, a mental health clinician, a specialist doctor and nurses.

“The patient’s muscles are completely relaxed, they are asleep for a few minutes while ECT is administered and they don’t feel a thing.

“It’s very safe. Safer than dental surgery in fact.”

The therapy leads to improved quality of life in both the short and long-term, Dr.Khan has  asserted.

However, he hastens to add that it is crucial that ECT treatment be targeted to the right person. 

“The process of consultation – openly discussing the pros and cons of all options to achieve informed consent – is so important.

“The problem is that not all medical professionals are up to date on the latest research when it comes to ECT.

“As clinicians, we need to have an open mind of looking at every treatment we have on offer.

“How can you have a balanced and objective approach if you’re not equipped with the latest research and guidelines?”

He says the practice of ECT has come a long way, but there is still work to be done when it comes to educating the medical profession and the public on the myths and controversies around its use.

At the same time, he concedes that like all treatments, ECT does have its limitations.

“A possible side effect that needs to be considered is memory loss, but generally this is only of events that occur after ECT has been administered and it is nearly always short term and reversible.

“The adherence to the strict standards and guidelines that are in place today is paramount.

“Given to the wrong person, ECT will bring about side effects and controversy. Given to the right person, it may well save a life,” Khan adds.

Source-Medindia
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