ELECTROCONVULSIVE-THERAPY - A GUIDE FOR FAMILY PHYSICIANS

Electroconvulsive therapy, which works by creating a generalized seizu re, is used most frequently to treat medication-resistant depression. Other indications for electroconvulsive therapy include severe depress ion with suicidal ideation, acute mania and severe psychiatric illness with food and fluid refusal. Electroconvulsive therapy may be adminis tered as an inpatient or outpatient procedure. Treatments are usually administered three times a week for six to 12 treatments. Before this therapy is used, a thorough medical and anesthetic history should be o btained, and a complete physical examination, an electrocardiogram and appropriate laboratory studies should be performed to rule out anemia , electrolyte imbalances, and cardiopulmonary and neurologic risk fact ors. Heart rate and rhythm, oxygenation, blood pressure and, often, th e electroencephalogram are monitored continuously while the patient is anesthetized with a short-acting hypnotic agent and a muscle depolari zing agent. After electroconvulsive therapy, antidepressant or lithium therapy significantly reduces the symptom relapse rate.