How To Know Whether Local Ect Treatments Are Safe And Effective
In Britain, there is an independent regulatory body called the ECT Accreditation service.
The ECT Accreditation Service examines ECT units all over the country and rates their quality.
An ECT unit should tell you whether or not the Accreditation service approves of their ECT unit.
Outside of the U.K., there is not necessarily as much information about the quality of local ECT services.
Types Of Treatment For Drug Addiction
No single approach to drug treatment can be expected to work for everyoneespecially when each individual may be suffering from different types of substance use disorders and having somewhat unique treatment needs. To meet these diverse needs, treatment facilities may offer a number of levels of care in which a person can move into before, during, and after treatment in order to allow for an easier transition into sober life.
Many facilities offer 30-, 60- and 90-day programs and a persons length of stay is will be decided based on a number of factors and guidance from their treatment team. Though any treatment can provide some level of much needed benefit, research indicates that patients may experience better outcomes when they stay in treatment for 90 days or longer.4
Some of the treatment types and settings a person may benefit from include:
- Medical Detox: A supervised detox and withdrawal management period is often a necessary first step of substance rehabilitation. With certain types of substance dependencesuch as that to develop with chronic alcohol and opioid usethe resulting withdrawal symptoms can be intensely uncomfortable and, in some instances, potentially fatal. In situations like these, medical supervision is vital. Medical detox consists of 3 important components:4
- Evaluating the patient. This involves testing for the concentration of drugs in their system, taking a physical and mental health assessment, learning their health history, etc.
How To Prepare For Your Treatment
ECT sessions generally do not require much preparation, though you will need to go over the specifics with your doctor. Your doctor may give you orders to follow based on other health conditions you have or medications you take.
Since you will be put under anesthesia, your doctor will probably have you fast before the procedure, which typically means that you do not eat after midnight the night before your treatment.
If you smoke, you may be asked to refrain from smoking on the day of your treatment.
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What Is Drug Addiction Treatment
Drug addiction treatment varies in its approach based on the drugs involved and the individual needs of the person attempting recovery. However, there are several evidence-based approaches that are commonly utilized in modern treatment facilities and practiced by addiction treatment specialists.
Most recovery treatment involves different forms of behavioral therapy and counseling. For certain types of substance addiction and individual addiction-related issues, medications may also be prescribed to ease withdrawal symptoms and treat any co-occurring mental health issues.2
I Have A Living Problem
Buckhalters father described the past 19 months as Christmas every day. His son now worries about his credit score and getting to work on time instead of where to find drugs or how to scam cash.
Buckhalter is acutely aware of how far he has come and how lucky he is to be the lone U.S. beneficiary of this experiment. He works as a peer counselor in a Morgantown sober-living home, helping 15 men in various stages of recovery with the same tasks that once seemed overwhelming to him: How to find a job. How to get an ID. How to obtain health care.
The former elite athlete plays on a softball team composed of people in recovery, guys who huff and puff on the base paths. A few months ago, he helped while a resident of the house used naloxone to revive a woman who had overdosed at a homeless camp under a nearby bridge.
Buckhalter credits the leaders of West Virginia Sober Living for taking him under their wing after the surgery, giving him a job and helping him begin his road back. He also feels a responsibility to make amends for the harm he has caused and to pass on the gift he has received.
But he is not yet ready to look too far into the future. Mostly, at 35, he wants a normal life. And he recognizes hes not there yet.
I still struggle with those things. Im definitely not where I would say I want to be.
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How Shock Therapy Feels
When you awake from the anesthesia, you may be confused and tired. You will likely experience short-term memory loss around the time of the procedure. With multiple treatments, this may increase. Adverse cognitive effects tend to be the most concerning factors around ECT and tend to affect the frequency and duration of treatments and whether ECT is offered at all. Your vital signs will be monitored closely after the shock treatment to ensure proper recovery. You may feel head, muscle or back pain. Such discomfort tends to be relieved by mild medications. If any post-treatment effect is concerning you, you should talk to the treating physician immediately.
Ect In Mental Health Treatment
If you are considering ECT for mental health treatment, you should discuss the risks and benefits of ECT treatment with your psychiatrist. If you are considering ECT for depression treatment, you should also be aware of the potential non-medication treatment alternatives available to you.
Treatment for mental health conditions is vital for maintaining health and function. If you are seeking treatment for mental health conditions that stem from addiction, The Recovery Village can help you understand and manage them appropriately. Our expert staff has extensive experience in the treatment of mental health conditions and co-occurring substance use disorders. We will help you to identify resources to guide you toward a more stable and sustainable life. Make the call today.
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Iiid2behavioral Completion Model Of Electrical Aversive Therapy
Evidence reviewed by McConaghy in 1977 indicated that the outcome of aversive therapy in homosexuality was similar to that of systematic desensitization. It had been observed clinically that many subjects seeking treatment reported they had tried to control homosexual or paraphilic urges in situations where they had expressed such urges previously. However, when attempting this control they experienced increasing tension that they found so aversive as to force them to act upon the urges. It was theorized that a neurophysiological behavior completion mechanism existed that produced heightened arousal, experienced as tension, if subjects did not complete a habitual behavior, when they were exposed to cues to carry out the behavior, such as situations where they had carried out the behavior previously. The association of excitatory and inhibitory stimuli in aversive procedures was considered to reduce or inhibit this arousal. Evidence that conflicting stimuli produced activity in forebrain structures in cats with resultant reduction in anxiety and fear was provided by a 1977 study of Thomas and De Wald.
Steven Taylor, in, 2002
What Does Electroconvulsive Therapy Cost
The cost of electroconvulsive therapy is estimated to be between $300 to $1000 per treatment. Since most people will undergo anywhere from six to 12 treatments along with additional maintenance treatments, the total ECT cost may exceed $10,000 per year.
The cost of electroconvulsive therapy will usually be at least partially covered by insurance plans that offer coverage for psychiatric disorders.
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How Does Shock Therapy Work
Even though ECT has been around for nearly 90 years, scientists still are not quite sure why or how it benefits some people with depression.
What researchers do know is what neurons do, which is send electrical signals back and forth. These signals tell the brain to release specific chemicals. When the brain undergoes ECT, an increase in beneficial neurochemicals like serotonin or dopamine may be released.
ECT may also impact the neurons in other ways, such as by stimulating the development of new brain cells or connections, or by affecting the electrical activity in the parts of the brain that are associated with mood regulation.
Why Is Electroconvulsive Therapy So Controversial
The controversy of electroconvulsive therapy comes mostly from its early use without anesthesia and the injuries this caused. ECT has been stigmatized in the media and films by its depictions as a brutal and painful therapy. Since its early use, research has improved the treatment and made it more safe and effective for patients.
The controversy of electroconvulsive therapy is also related to the evidence and ethics of the procedure. Some physicians still question the effectiveness of the treatment versus the risks of side effects it can cause. There is documented evidence of it being effective for people who have no other treatment options. However, other studies have shown that relapse of the mental health disorder is common following the procedure. Given that it may not offer a long-term solution, some physicians argue ECT is not worth the risk unless its used as a last resort.
A person considering ECT should discuss the risks and benefits with their physician.
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Ect Still Has Risks And Side Effects Today
Even today, ECT has serious risks. While modern ECT is painless, it can still be dangerous.
If ECT were safe, doctors would recommend ECT to clinically depressed patients in general.
However, it is still risky and, therefore, only used for severe and treatment-resistant psychological issues.
The most worrying side effect of ECT is memory loss. Events around the time of the treatment can vanish from the patients mind.
In the worst cases, ECT can lead to long term memory problems. The procedure is still risky, although less so than in the past.
In the past, some people injured themselves during ECT seizures.
Muscle relaxants today minimise the odds of this happening, but damaged bones and teeth are still possible.
Some people also experience odd moods between treatments. ECT does not always have a positive psychological effect.
People can be confused or restless between treatments. Sometimes, ECT does not benefit a patient.
Longer-term side effects can be severe, including difficulty learning new information.
A persons ambition, energy, and creativity may slowly decline if they repeatedly undergo ECT.
While ECT is usually harmless, it is not a safe treatment with no risk of severe side effects.
Doctors consider ECT to be worth the risks in some cases, but it can be dangerous.
Relapse Rates For Addiction Resemble Those Of Other Chronic Diseases Such As Diabetes Hypertension And Asthma
Like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addictions powerful disruptive effects on the brain and behavior and to regain control of their lives. The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with symptom recurrence rates similar to those for other well-characterized chronic medical illnessessuch as diabetes, hypertension, and asthma that also have both physiological and behavioral components.
Unfortunately, when relapse occurs many deem treatment a failure. This is not the case: Successful treatment for addiction typically requires continual evaluation and modification as appropriate, similar to the approach taken for other chronic diseases. For example, when a patient is receiving active treatment for hypertension and symptoms decrease, treatment is deemed successful, even though symptoms may recur when treatment is discontinued. For the addicted individual, lapses to drug abuse do not indicate failurerather, they signify that treatment needs to be reinstated or adjusted, or that alternate treatment is needed .
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What Alternative Treatments Are Used For Depression
Alternative treatments can sometimes provide relief that traditional Western medicine cannot. While some alternative therapies have become accepted as part of modern health care practice, others still have not been proven safe or effective.
Whether or not they are scientifically proven, alternative therapies, by providing forms of relaxation and relief from stress, may have a place in healing and general health and well-being. Examples of alternative therapies include acupuncture, guided imagery, chiropractic treatments, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, and massage.
In general, alternative therapies by themselves are reasonable to use for mild but not more severe forms of clinical depression.
The Electroconvulsive Therapy Process
An ECT treatment regimen will typically include sessions two to three days a week for a total of six to 12 treatments. The schedule works out to about one month of treatment, although the course may continue for longer.
During ECT, you will be under general anesthesia. You will not be aware of what is going on while you are undergoing the treatment.
Once you are under anesthesia, electrodes will be attached to your scalp in specific locations. The brain is then stimulated with a brief amount of electricity to induce a seizure that will last less than a minute.
Your healthcare provider will closely monitor you to make sure that the anesthesia and a muscle relaxant are working and that you are not experiencing any complications.
When shock therapy was first used 80 years ago, patients needed to be strapped to the table to keep them from moving during the seizure. Today, an anesthesiologist will give you a muscle relaxant to keep your body from shaking uncontrollably, reducing the risk of injury.
The entire process lasts about one minute. When the procedure is finished, you will rest in a recovery room until you wake up from the anesthesia, which typically takes about five to 10 minutes. You should be able to go home within an hour.
For the most part, you can go about the rest of your day, although because you had anesthesia, you will need someone to accompany you home since you will be advised not to drive.
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Continuation Electroconvulsive Therapy Vs Medication To Prevent Relapses In Patients With Major Depressive Disorder
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|First Posted : November 3, 1999Last Update Posted : December 20, 2005
- Study Details
The purpose of this study is to compare the safety and effectiveness of two treatments to prevent relapses in seriously ill patients with major depressive disorder who have responded to electroconvulsive therapy . Patients will either continue to receive ECT , or they will be treated with antidepressant medications.
ECT is a highly effective treatment for MDD however, relapses are a major concern. To prevent relapse in patients who have responded to ECT, the common treatment is antidepressants as continuation therapy . Relapses, however, can still occur even after antidepressant continuation therapy. This study will evaluate a potent antidepressant combination in order to prevent relapse. C-ECT is another option that needs to be tested.
An individual may be eligible for this study if he/she:
Has major depressive disorder and responds positively to ECT treatment and is 18 to 80 years old.
The Future Of Severe Depression Treatment
As effective as ECT can be for treatment-resistant depression, there is room for improvement and UT Southwestern is leading the charge. We are the only medical center in the U.S. participating in a National Institute of Mental Health-funded clinical study for magnetic seizure therapy . Along with the University of Toronto Centre for Addiction and Mental Health , we are enrolling patients to compare the effectiveness of right-unilateral ECT and MST.
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What Is Transcranial Magnetic Stimulation
While ECT uses an electric current to induce seizure, TMS creates a magnetic field to induce a much smaller electric current in a specific part of the brain without causing seizure or loss of consciousness. The current is caused by the magnetic field created by an electromagnetic coil that delivers the pulses through the forehead.
Approved by the FDA in 2008 for treatment-resistant depression, TMS works best in patients who have failed to benefit from one, but not two or more, antidepressant treatments. Also, unlike ECT, TMS does not require sedation and is administered on an outpatient basis. Patients undergoing TMS must be treated four or five times a week for four to six weeks.
Research has shown that TMS produces few side effects and is both safe and effective for medication-resistant depression. However, its effectiveness as currently performed appears to be less than that of ECT.
Seeking Treatment And Tms
Seeking recovery from addiction is often a harder process than people realize. There isnt a 1-stop shop to treat addiction. Every person is different, and what may work for 1 person wont necessarily work for someone else. If you or someone you love have suffered a relapse after going through rehabilitation, this is not the end of the road. Rather, the approach to treatment needs to be adjusted. If TMS is something you believe you could benefit from, then contact a treatment provider. They can also talk to you about other rehab options.
Reviewed by Certified Addiction Professional: December 7, 2018
David embarked on his journey into sobriety in June of 2005, which led him to his current career path as a Certified Professional Addiction Recovery Coach in private practice in Greater Nashville. David is also a public speaker and the author of two books. David is cohost of the weekly Positive Sobriety Podcast, as well as being a frequent contributor to various articles and recovery based materials. As a member of the National Association of Alcohol and Drug Abuse Counselors , David works closely with area treatment centers, recovery orientated nonprofit organizations, as well as being a keynote speaker for various recovery-focused events.
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