Increasingly, electroconvulsive therapy (ECT) is recognized as a
proven, effective, and even life-saving intervention in certain
mood and thought disorders when other treatments have had little or
no effect. Despite the proven efficacy and safety of this standard
treatment in psychiatry, its availability is variable. Part of this
disparity in access is related to misunderstanding by laypersons
regarding the treatment and its potential adverse effects. Adequate
education and training of psychiatrists and their support staff are
essential to ensuring patients' access to this vital treatment
tool. The authors of Clinical Manual of Electroconvulsive Therapy
offer this expansive yet reader-friendly volume to help
psychiatrists successfully incorporate ECT into their clinical
practices. It is also a valuable resource for medical students and
psychiatric residents, as well as experienced clinicians and
researchers.
The book updates the 1985 original and 1998 second edition of
Electroconvulsive Therapy: A Programmed Text, and provides readers
with a scheduled approach to understanding the fundamental concepts
of ECT while offering practical guidance for establishing and
maintaining an ECT program. Topics include the history of ECT,
indications for use, patient referral and evaluation, the basics of
ECT, clinical applications, anesthetics and other medications,
seizure monitoring and management, ictal motor and cardiovascular
response, adverse effects, and maintenance ECT. Included are
detailed descriptions of recent advances including ultra-brief
pulse ECT, oxygenation, muscle relaxation, and other modifications
that have made this very effective treatment much safer and more
acceptable to patients. Currently, it is estimated that more than
100,000 people receive ECT treatments each year in the U.S.
Indications for use of ECT are for mood disorders such as major
depressive disorder and mania, and thought disorders including
schizophrenia and schizoaffective disorder. Indications for use in
other psychiatric disorders and general medical disorders such as
Parkinson's disease, which appears to respond especially well to
ECT, are reviewed as well. This highly-readable manual is a
must-have for the library of any clinician interested in or
currently practicing ECT: - Provides background information on the
origins of psychiatric treatments preceding ECT, including efforts
using hydrotherapy and insulin comas - Includes an algorithm for
the management of ECT seizure adequacy- Discusses contraindications
as well as the potential adverse effects of ECT, including
cognitive changes and cardiovascular complications- Provides
specific information about ECT device manufacturers, reprintable
patient information sheets, and a written informed consent form
This clinical manual comprehensively explores and explains the
available knowledge regarding ECT -- based on extensive research
over the past 70 years -- in order to help potential ECT clinicians
make informed choices about the development and management of their
ECT program.
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