Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-5xszh Total loading time: 0 Render date: 2024-03-28T12:46:14.334Z Has data issue: false hasContentIssue false

Chapter 7 - Treatment: ECT, Medications, and More

Published online by Cambridge University Press:  10 September 2009

Conrad M. Swartz
Affiliation:
Southern Illinois University School of Medicine, Springfield
Edward Shorter
Affiliation:
University of Toronto
Get access

Summary

The enormous personal improvements we have seen in patients who receive ECT and AMMs, and the suffering and incapacitation these patients escape, are beyond the ability of language to convey. We can spell out how to provide these treatments, and do so here. The information provided in this chapter is primarily for physicians, yet patients and their families can have a front row seat as they see how this fearful illness must properly be treated.

Electroconvulsive therapy

Catatonia, suicidal intent or activity, dangerous or unpredictable agitation, weight loss, inability to swallow medication, and severe impairment of self-care are reasons to begin ECT urgently in patients with an ECT-responsive type of psychotic depression. Failure of a previous medication trial, need for inpatient confinement, need for a prompt or reliable response (i.e., cannot wait), medication intolerance (because of age or medical problems), or patient preference are compelling reasons to choose ECT as the next treatment. Of course, patient preference is influenced by what the physician chooses to say (or omit) about the up- and downsides of treatment alternatives, and how this meshes with patients' desires for reliability, promptness, comfort, and avoidance of impairment or disempowerment.

A meta-analysis of forty-four treatment studies of psychotic depression concluded that ECT tends to be superior to the antipsychotic-TCA combination and is distinctly superior to tricyclics alone (Parker et al., 1992).

Type
Chapter
Information
Psychotic Depression , pp. 192 - 234
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×