Even with the rise of newer neuropsychiatric brain stimulation methods, electroconvulsive therapy (ECT) remains a widely used treatment for severe mental illness-and perhaps the most effective for serious mental illness. Optimal treatment requires that psychiatrists be skilled in diagnosis and familiar with the techniques of treatment. That's where Principles and Practice of Electroconvulsive Therapy comes in. With its up-to-date, comprehensive coverage of all aspects of ECT, this is an unrivaled resource for psychiatrists, whether in practice or still in training, striving for maximum treatment efficacy. The book begins with an overview of what ECT is and how it is carried out, followed by a brief history of the therapy, from its earliest applications to its use in modern times. The guide follows the typical course of treatment, discussing the following: - Understanding the indications for ECT and selecting patients who might benefit from this therapy-whether they suffer from depression, mania, schizophrenia, or catatonia - Educating patients and their families on ECT and obtaining patient consent - Conducting a pretreatment medical evaluation and understanding the role of anesthesia - Managing an individual ECT treatment, including choosing the electrical stimulus dose and parameter combination, delivering the electrical stimulus, assisting with recovery problems, etc. - Overseeing the course of treatments, particularly for practitioners not personally conducting the treatments - Managing patients after a course of treatments and preventing relapse - Assessing and managing the memory side effects of ECT The final chapter examines other neuropsychiatric stimulation therapies in relation to ECT and explains how to choose among them. All chapters conclude with easily referenced key points that summarize the most salient ideas. Readers seeking to further educate themselves on ECT will also benefit from the exhaustive reference list. Though particularly useful for psychiatrists and psychiatric residents, Principles and Practice of Electroconvulsive Therapy, with its straightforward style, is a ready resource for any mental health or medical professionals interested in ECT.

Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition. The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation "should" to distinguish them from recommendations that are advisable but nonessential (with the designations "encouraged," "suggested," "considered"). The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging. This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations. Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines.

This is a pioneering book about the use of ECT in adolescents who are diagnosed with severe, disabling psychiatric disorders or fail conventional treatment. Included are a review of the literature, firsthand experience of the authors and case descriptions making it an invaluable guide to treatment.

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.

The renowned Principles and Practice of Geriatric Psychiatry, now in its third edition, addresses the social and biological concepts of geriatric mental health from an international perspective. Featuring contributions by distinguished authors from around the world, the book offers a distinctive angle on issues in this continually developing discipline. Principles and Practice of Geriatric Psychiatry provides a comprehensive review of: geriatric psychiatry spanning both psychiatric and non-psychiatric disorders scientific advances in service development specific clinical dilemmas New chapters on: genetics of aging somatoform disorders epidemiology of substance abuse somatoform disorders care of the dying patient Continuing the practice of earlier editions, the major sections of the book address aging, diagnosis and assessment and clinical conditions, incorporating an engaging discussion on substance abuse and schizophrenic disorders. Shorter sections include the presentation of mental illness in elderly people from different cultures—one of the most popular sections in previous editions. Learning and behavioural studies, as well as models of geriatric psychiatry practice, are covered extensively. This book provides a detailed overview of the entire range of mental illness in old age, presented within an accessible format. Principles and Practice of Geriatric Psychiatry is an essential read for psychiatrists, geriatricians, neurologists and psychologists. It is of particular use for instructors of general psychiatry programs and their residents.

Few mental illness treatments are more reviled in the public mind than Electroconvulsive Shock Therapy. However, in reality, ECT is a safe and effective treatment for cases of clinical depression and catatonia that are unresponsive to drug therapy. Also, unlike drugs, ECT has relatively few side effects. The authors argue that it is time for this historically stigmatized procedure to be reevaluated. The authors make a strong case for greater professional and public attention to the procedure's benefits, offering historical coverage of ECT-related movements, legislation, public and practitioner sentiment and the introduction of competing treatments. This volume will not only garner the interest of mental health professionals, but will call on policy makers and ethicists to examine its arguments.

This book is the need-to-know guide to the practice of modern electroconvulsive therapy.

Electroconvulsive therapy (ECT) is a psychiatric treatment involving the induction of a seizure through the transmission of electricity in the brain. Because of exploitation movies and greatly heightened drug company promotional activities ECT was used less frequently in the 1980s and 1990s. Eventually these movies were understood as unrealistic. Now these drugs are increasingly recognized as dangers to body health. Because of recent refinements and a far better scientific understanding of the clinical procedures and mechanisms underpinning ECT, this treatment modality has seen a resurgence in use and widespread appreciation of its safety. This book is the new definitive reference on electroconvulsive and neuromodulation therapies. It comprehensively covers the scientific basis and clinical practice of ECT as well as comparisons between ECT and medication therapies including the new generation of antipsychotic drugs. It also provides readers with administrative perspectives and specific details for the management of this modality in clinical practice. The new forms of nonconvulsive electrical and magnetic brain stimulation therapy are also covered in detail, in a separate section. The chapter authors are leading scholars and clinicians.

The fourth edition of this popular Handbook provides the latest guidance on prescribing and administering electroconvulsive therapy (ECT). Leading researchers and practitioners review new research on ECT and related treatments, including their efficacy in children and adolescents, and in those with bipolar disorder and neurological conditions. With a focus on safe provision and minimisation of side effects, it provides the reader with practical, evidence-based advice. The book has been substantially revised: references have been updated throughout; related treatment modalities such as rTMS, tCDS and ketamine are covered in greater depth; and current administrative and legal framework guidelines are clearly outlined. An essential reference manual for consultant and trainee clinical psychiatrists, as well as ECT practitioners. This guide will benefit clinical teams looking after complex cases of depression, as well as those involved in the care of other people for whom ECT may be recommended.

Basic electricity -- Electrical brain -- Electroconvulsive therapy -- Vagus nerve stimulation -- Transcranial magnetic stimulation -- Deep brain stimulation and cortical stimulation -- Transcranial direct current stimulation -- Other techniques.