1. ELECTROCONVULSIVE THERAPY ( ECT ) doc.MUDr.Alexandra Žourková,CSc. Dept. of Psychiatry, Dept. of Psychiatry, Masaryk University, Brno Masaryk University, Brno

2. ELECTROCONVULSIVE THERAPY ( ECT ) P R I N C I P L E O F E C T  THE INDUCTION OF A GRAND MAL SEIZURE BY MEANS OF AN ELECTRICAL SEIZURE BY MEANS OF AN ELECTRICAL PULSE THROUGH THE BRAIN PULSE THROUGH THE BRAIN  THE PERSON IS UNDER ANESTHESIA

3. ELECTROCONVULSIVE THERAPY ( ECT ) MECHANISM OF ACTION  UNKNOWN EXACTLY ( NEUROTRANSMITTERS IN THE ( NEUROTRANSMITTERS IN THE BRAIN – GABA, ADRENALIN, BRAIN – GABA, ADRENALIN, SEROTONIN, DOPAMINE, SEROTONIN, DOPAMINE, ENDOGENOUS OPIATES …) ENDOGENOUS OPIATES …)

4. ADMINISTRATION H I S T O R I C A L ( AWAKE AND NOT PREMEDICATED, COMPLICATIONS )

5. ADMINISTRATION N O W  ATROPINE (REDUCE SECRETION)  GENERAL SHORT – ACTING ANESTHESIA (REDUCE ANXIETY AND DISCOMFORT) (REDUCE ANXIETY AND DISCOMFORT)  DEPOLARIZING MUSCLE RELAXANT (ELIMINATE COMPLICATIONS) (ELIMINATE COMPLICATIONS)  BILATERALLY ADMINISTRATION  UNILATERALLY ADMINISTRATION

6.  MEDICAL HISTORY AND PHYSICAL EXAMINATION PHYSICAL EXAMINATION  LABORATORY TEST  PRETREATMENT REGIMEN  INFORMAL CONSENT CLINICAL EVALUATION  ELECTRICAL STIMULUS 70 – 110 V FOR 0,1 – 0,5 s / 200 – 1600mA 70 – 110 V FOR 0,1 – 0,5 s / 200 – 1600mA  USUALLY NUMBER OF ECT 6 – 10 THREE TIMES WEEKLY 6 – 10 THREE TIMES WEEKLY

7.  MAJOR DEPRESSIVE EPIZODES (WORKS MORE QUICKLY, IS SAFER, (WORKS MORE QUICKLY, IS SAFER, IS PROBABLY MORE EFFECTIVE THAN TCAS) IS PROBABLY MORE EFFECTIVE THAN TCAS) I N D I C A T I O N  ACUTE MANIA  SCHIZOFRENIA – AFFECTIVE AND CATATONIC SYMPTOMS CATATONIC SYMPTOMS

8.  A SPACE OCCUPYING CEREBRAL LESION THAT CAUSES INCREASED LESION THAT CAUSES INCREASED INTRACRANIAL PRESSURE INTRACRANIAL PRESSURE ABSOLUTE CONTRAINDICATION

9. M O S T C O M M O N  TRANSITORY MEMORY LOSS S I D E E F F E C T S  HEADACHE  MUSCLE ACHES

10. L E S S C O M M O N  INCREASE IN PERMEABILITY OF THE BLOOD-BRAIN BARRIER BLOOD-BRAIN BARRIER S I D E E F F E C T S  SYSTEMIC HYPERTENSION  APNEA  CARDIAC ARRHYTHMIAS

11. References :  Waldinger R.J.: Psychiatry for medical students, Washington, DC : American Psychiatric Press, 1997 Kaplan HI, Sadock BJ, Grebb JA.: Kaplan and Sadock´s synopsis of psychiatry, Baltimore: Williams and Wilkins, 1997 Kaplan HI, Sadock BJ, Grebb JA.: Kaplan and Sadock´s synopsis of psychiatry, Baltimore: Williams and Wilkins, 1997