Electroconvulsive therapy - Knowledge (XXG)

858:, both retrograde (for events occurring before the treatment) and anterograde (for events occurring after the treatment). Memory loss and confusion are more pronounced with bilateral electrode placement rather than unilateral, and with outdated sine-wave rather than brief-pulse currents. The use of either constant or pulsing electrical impulses also varied the memory loss results in patients. Patients who received pulsing electrical impulses, as opposed to a steady flow, seemed to incur less memory loss. The vast majority of modern treatment uses brief pulse currents. A greater number of treatments and higher electrical charges (stimulus charges) have also been associated with a greater risk of memory impairment. 1354:

opportunity to accept or reject the treatment. The form states how many treatments are recommended and also makes the patient aware that consent may be revoked and treatment discontinued at any time during a course of ECT. The US Surgeon General's Report on Mental Health states that patients should be warned that the benefits of ECT are short-lived without active continuation treatment in the form of drugs or further ECT, and that there may be some risk of permanent, severe memory loss after ECT. The report advises psychiatrists to involve patients in discussion, possibly with the aid of leaflets or videos, both before and during a course of ECT.

1507:. However, ECT is often only used as a treatment of last resort. To be considered for ECT, often testing such as an EKG and lab tests are required, in addition to a physical and neurological exam. Certain medications and conditions, such as cardiac conditions or hypertension, may disqualify a patient from ECT. Patients should give proper informed consent before ECT is performed. In the United States, ECT is performed under general anesthesia. Both trained health professionals with experience in ECT administration as well as a specifically trained and certified anesthesiologist should administer the procedure and anesthesia respectively. 894:, stated in a 2007 interview that, "There are a number of well-designed studies that show ECT does not cause brain damage and numerous reports of patients who have received a large number of treatments over their lifetime and have suffered no significant problems due to ECT." Kellner cites a study purporting to show an absence of cognitive impairment in eight subjects after more than 100 lifetime ECT treatments. Kellner stated "Rather than cause brain damage, there is evidence that ECT may reverse some of the damaging effects of serious psychiatric illness." Two meta-analyses find that ECT is associated with brain matter growth. 1243:

or maintenance ECT with further treatments at weekly, fortnightly or monthly intervals. A few psychiatrists in the US use multiple-monitored ECT (MMECT), where patients receive more than one treatment per anesthetic. Electroconvulsive therapy is not a required subject in US medical schools and not a required skill in psychiatric residency training. Privileging for ECT practice at institutions is a local option: no national certification standards are established, and no ECT-specific continuing training experiences are required of ECT practitioners.

464:(APA) task force report on electroconvulsive therapy (to be followed by further reports in 1990 and 2001). The report endorsed the use of ECT in the treatment of depression. The decade also saw criticism of ECT. Specifically, critics pointed to shortcomings such as noted side effects, the procedure being used as a form of abuse, and uneven application of ECT. The use of ECT declined until the 1980s, "when use began to increase amid growing awareness of its benefits and cost-effectiveness for treating severe depression". In 1985, the 1125: 1963:. Prepared for the January 27–28, 2011 meeting of the Neurological Devices Panel Meeting to Discuss the Classification of Electroconvulsive Therapy Devices (ECT). Quote, p. 38: "Three major practice guidelines have been published on ECT. These guidelines include: APA Task Force on ECT (2001); Third report of the Royal College of Psychiatrists' Special Committee on ECT (2004); National Institute for Health and Clinical Excellence (NICE 2003; NICE 2009). There is significant agreement between the three sets of recommendations." 1333:

2011 vote by the FDA's Neurological Devices Advisory Panel to recommend that FDA maintain ECT devices in the Class III device category for high risk devices, except for patients with catatonia, major depressive disorder, and bipolar disorder. This may result in the manufacturers of such devices having to do controlled trials on their safety and efficacy for the first time. In justifying their position, panelists referred to the memory loss associated with ECT and the lack of long-term data.

974: 377:. Cerletti had noted a shock to the head produced convulsions in dogs. The idea to use electroshock on humans came to Cerletti when he saw how pigs were given an electric shock before being butchered to put them in an anesthetized state. Cerletti and Bini practiced until they felt they had the right parameters needed to have a successful human trial. Once they started trials on patients, they found that after 10–20 treatments the results were significant. Patients had much improved. 1429:

62 of the Act, if the treating psychiatrist says the need for treatment is urgent they may start a course of ECT without authorization. From 2003 to 2005, about 2,000 people a year in England and Wales were treated without their consent under the Mental Health Act. Concerns have been raised by the official regulator that psychiatrists are too readily assuming that patients have the capacity to consent to their treatments, and that there is a worrying lack of independent

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Psychiatrists, with a later survey in 1998 finding that minimum standards were largely adhered to, but that two-thirds of clinics still fell short of current guidelines, particularly in the training and supervision of junior doctors involved in the procedure. A voluntary accreditation scheme, ECTAS, was set up in 2004 by the Royal College, and as of 2017 the vast majority of ECT clinics in England, Wales, Northern Ireland and the Republic of Ireland have signed up.

395:. Through the 1940s and 1950s, the use of ECT became widespread. At the time the ECT device was patented and commercialized abroad, the two Italian inventors had competitive tensions that damaged their relationship. In the 1960s, despite a climate of condemnation, the original Cerletti-Bini ECT apparatus prototype was contended by scientific museums between Italy and the US. The ECT apparatus prototype is now owned and displayed by the Sapienza 1062: 1476:, ECT has been heavily restricted since 2014, after a bill passed with bipartisan support introducing restrictions on ECT, which were welcomed by mental health experts. Children under 14 are prohibited from receiving ECT, while those aged 14 to 18 must have informed consent approval from the Mental Health Tribunal. The law imposes a $ 15,000 fine on anyone who performs ECT on a child under the age of 14. 1772: 49: 958: 245: 1012:"). Some psychiatrists use dose titration, some still use "fixed dose" (that is, all patients are given the same dose) and others compromise by roughly estimating a patient's threshold according to age and sex. Older men tend to have higher thresholds than younger women, but it is not a hard and fast rule, and other factors, for example drugs, affect seizure threshold. 1133: 419:(succinylcholine), a safer synthetic alternative to curare, in 1951 led to the more widespread use of "modified" ECT. A short-acting anesthetic was usually given in addition to the muscle relaxant in order to spare patients the terrifying feeling of suffocation that can be experienced with muscle relaxants. 1737:

Two analyses of large numbers of films using ECT scenes found that almost all presented fictional settings that were unrelated to real treatment routines and were apparently aimed at stigmatizing ECT as a tool of repression and of mind and behavior control - having effects of memory-erosion, pain and

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petitioned the FDA to reclassify ECT devices from Class III (high-risk) to Class II (medium-risk). A similar reclassification proposal in 2010 did not pass. In 2018, the FDA re-classified ECT devices as Class II devices when used to treat catatonia or a severe major depressive episode associated with

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refusing ECT then they should not be given it; and even if they do not have an advance decision, the psychiatrist must obtain an independent second opinion (which is also the case if the patient is under age of consent). However, there is an exception regardless of consent and capacity; under Section

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Approximately a third did not feel they had freely consented to ECT even when they had signed a consent form. The proportion who feel they did not freely choose the treatment has actually increased over time. The same themes arise whether the patient had received treatment a year ago or 30 years ago.

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Most modern ECT devices deliver a brief-pulse current, which is thought to cause fewer cognitive effects than the sine-wave currents which were originally used in ECT. A small minority of psychiatrists in the US still use sine-wave stimuli. Sine-wave is no longer used in the UK or Ireland. Typically,

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In the US, the medical team performing the procedure typically consists of a psychiatrist, an anesthetist, an ECT treatment nurse or qualified assistant, and one or more recovery nurses. Medical trainees may assist, but only under the direct supervision of credentialed attending physicians and staff.

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Considerable controversy exists over the effects of ECT on brain tissue, although a number of mental health associations—including the APA—have concluded that there is no evidence that ECT causes structural brain damage. A 1999 report by the US Surgeon General states: "The fears that ECT causes gross

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indicated that more than 60% of respondents had some knowledge about the main aspects of ECT. Participants were generally opposed to the use of ECT on depressed individuals with psychosocial issues, on children, and on involuntary patients. Public perceptions of ECT were found to be mainly negative.

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Surveys of public opinion, the testimony of former patients, legal restrictions on the use of ECT and disputes as to the efficacy, ethics and adverse effects of ECT within the psychiatric and wider medical community indicate that the use of ECT remains controversial. This is reflected in the January

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allows people to be treated against their will. This law has extra protections regarding ECT. A patient capable of making the decision can decline the treatment, and in that case treatment cannot be given unless it will save that patient's life or is immediately necessary to prevent deterioration of

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In the United States, ECT is usually given three times a week; in the United Kingdom, it is usually given twice a week. Occasionally it is given on a daily basis. A course usually consists of 6–12 treatments, but may be more or fewer. Following a course of ECT some patients may be given continuation

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In the mid-1990s in Texas, ECT was used in about one third of psychiatric facilities and given to about 1,650 people annually. Usage of ECT has since declined slightly; in 2000–01 ECT was given to about 1,500 people aged from 16 to 97 (in Texas it is illegal to give ECT to anyone under sixteen). ECT

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to inhibit salivation. In a minority of countries such as Japan, India, and Nigeria, ECT may be used without anesthesia. The Union Health Ministry of India recommended a ban on ECT without anesthesia in India's Mental Health Care Bill of 2010 and the Mental Health Care Bill of 2013. The practice was

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were introduced and the use of unilateral electrode placement was recommended. The 1985 NIMH Consensus Conference confirmed the therapeutic role of ECT in certain circumstances. The American Psychiatric Association released its second task force report in 1990 where specific details on the delivery,

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In the 1940s and early 1950s, ECT was usually given in an "unmodified" form, without muscle relaxants, and the seizure resulted in a full-scale convulsion. A rare but serious complication of unmodified ECT was fracture or dislocation of the long bones. In the 1940s, psychiatrists began to experiment

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had ECT as a teenager to "cure" his homosexuality. He later claimed it had induced multiple personality disorder, and resulted in his hatred of psychiatrists. After Reed's death, his sister denied the ECT treatments were intended to suppress his "homosexual urges", asserting that their parents were

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In most states in the US, a judicial order following a formal hearing is needed before a patient can be forced to undergo involuntary ECT. However, ECT can also be involuntarily administered in situations with less immediate danger. Suicidal intent is a common justification for its involuntary use,

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In the UK, in order for consent to be valid it requires an explanation in "broad terms" of the nature of the procedure and its likely effects. One review from 2005 found that only about half of patients felt they were given sufficient information about ECT and its adverse effects and another survey

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Accurate statistics about the frequency, context and circumstances of ECT in the US are difficult to obtain because only a few states have reporting laws that require the treating facility to supply state authorities with this information. In 13 of the 50 states, the practice of ECT is regulated by

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The electrodes deliver an electrical stimulus. The stimulus levels recommended for ECT are in excess of an individual's seizure threshold: about one and a half times seizure threshold for bilateral ECT and up to 12 times for unilateral ECT. Below these levels treatment may not be effective in spite

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are recommended. In many instances of active mood disorder during pregnancy, the risks of untreated symptoms may outweigh the risks of ECT. Potential complications of ECT during pregnancy can be minimized by modifications in technique. The use of ECT during pregnancy requires thorough evaluation of

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who do not respond to other treatments, but is a first-line treatment for severe or life-threatening catatonia. There is a plethora of evidence for its efficacy, notwithstanding a lack of randomised controlled trials, such that "the excellent efficacy of ECT in catatonia is generally acknowledged".

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In the UK in 1980, an estimated 50,000 people received ECT annually, with use declining steadily since then to about 12,000 per annum in 2002. It is still used in nearly all psychiatric hospitals, with a survey of ECT use from 2002 finding that 71 percent of patients were women and 46 percent were

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In bilateral ECT, the two electrodes are placed on opposite sides of the head. Usually bitemporal placement is used, whereby the electrodes are placed on the temples. Uncommonly bifrontal placement is used; this involves positioning the electrodes on the patient's forehead, roughly above each eye.

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usually resolves 2–4 weeks after treatment, whereas retrograde amnesia (which develops gradually after repeated treatments in the initial course) usually takes weeks to months to resolve, and amnesia rarely persist for more than 1 year. Retrograde amnesia after ECT usually affects autobiographical

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Other estimates regarding the response rate in treatment resistant depression vary between 60–80%, with a remission rate of 50–60%. In addition to reducing symptoms of depression and inducing relapse, ECT has also been shown to reduce the risk of suicide, improve functional outcomes and quality of

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had a nervous breakdown and spent time in and out of psychiatric hospitals between 1961 and 1963. He was diagnosed with paranoid schizophrenia and clinical depression as a result of an evaluation conducted by psychoanalysts, and was treated with electroconvulsive therapy on numerous occasions, a

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In the US, this doctrine places a legal obligation on a doctor to make a patient aware of the reason for treatment, the risks and benefits of a proposed treatment, the risks and benefits of alternative treatment, and the risks and benefits of receiving no treatment. The patient is then given the

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There is wide variation in ECT use between different countries, different hospitals, and different psychiatrists. International practice varies considerably from widespread use of the therapy in many Western countries to a small minority of countries that do not use ECT at all, such as Slovenia.

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in England and Wales, issued guidance on the use of ECT. Its use was recommended "only to achieve rapid and short-term improvement of severe symptoms after an adequate trial of treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening in

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would reduce a patient to a more manageable submissive state, ECT helped to improve mood in those with severe depression. A survey of psychiatric practice in the late 1980s found that an estimated 100,000 people received ECT annually, with wide variation between metropolitan statistical areas.

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will be incomplete, and evidence has shown that ECT can result in persistent or permanent memory loss". It is the purported effects of ECT on long-term memory that give rise to much of the concern surrounding its use. However, the methods used to measure memory loss are non-specific, and their

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ECT was introduced in China in the early 1950s and while it was originally practiced without anesthesia, as of 2012 almost all procedures were conducted with it. As of 2012, there are approximately 400 ECT machines in China, and 150,000 ECT treatments are performed each year. Chinese national

573:, despite a Canadian guideline and some experts arguing for using ECT as a first line treatment, ECT is generally used only when one or other treatments have failed, or in emergencies, such as imminent suicide. ECT has also been used in selected cases of depression occurring in the setting of 1282:

editorial points out, is only a policy statement and psychiatrists may deviate from it if they see fit. Adherence to standards has not been universal in the past. A survey of ECT use in 1980 found that more than half of ECT clinics failed to meet minimum standards set by the Royal College of

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There is little agreement on the most appropriate follow-up to ECT for people with major depressive disorder. The initial course of ECT is then transitioned to maintenance ECT, pharmacotherapy or both. When ECT is stopped abruptly, without a bridge to maintenance ECT or medications (usually

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In 1976, Dr. Blatchley demonstrated the effectiveness of his constant current, brief pulse device ECT. This device eventually largely replaced earlier devices because of the reduction in cognitive side effects, although as of 2012 some ECT clinics still were using sine-wave devices.

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of 82 studies found that the rate of major adverse cardiac events with ECT was 1 in 39 patients or about 1 in 200 to 500 procedures. The risk of death with ECT however is low. If death does occur, cardiovascular complications are considered as causal in about 30% of individuals.

229:. ECT can differ in its application in three ways: electrode placement, treatment frequency, and the electrical waveform of the stimulus. These treatment parameters can pose significant differences in both adverse side effects and symptom remission in the treated patient. 493:

Though ECT use declined with the advent of modern antidepressants, there has been a resurgence of ECT with new modern technologies and techniques. Modern shock voltage is given for a shorter duration of 0.5 milliseconds where conventional brief pulse is 1.5 milliseconds.

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ECT is usually done from 6 to 12 times in 2 to 4 weeks but can sometimes exceed 12 rounds. It is also recommended to not do ECT more than 3 times per week. Evidence suggest that ECTs for depression may be stopped if there is no improvement during the first six sessions.

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According to the US Surgeon General, involuntary treatment is uncommon in the US and is typically used only in cases of great extremity, and only when all other treatment options have been exhausted. The use of ECT is believed to be a potentially life-saving treatment.

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found that the psychiatry trainees were more knowledgeable and had more favorable opinions of ECT than did the other groups. More members of the general public believed that ECT was used for control or punishment purposes than medical students or psychiatry trainees.

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described patients' perspectives on the adequacy of informed consent before ECT. The study found that "About half (45–55%) of patients reported they were given an adequate explanation of ECT, implying a similar percentage felt they were not." The authors also stated:

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In the US, ECT devices are manufactured by two companies, Somatics, which is owned by psychiatrists Richard Abrams and Conrad Swartz, and Mecta. In the UK, the market for ECT devices was long monopolized by Ectron Ltd, which was set up by psychiatrist Robert Russell.

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Neuroimaging prior to ECT may be useful for detecting intracranial pressure or mass given that patients respond less when one of these conditions exist. Nonetheless, it is not indicated due to high cost and low prevalence of these conditions in patients needing ECT.

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In one of the few jurisdictions where recent statistics on ECT usage are available, a national audit of ECT by the Scottish ECT Accreditation Network indicated that 77% of patients who received the treatment in 2008 were capable of giving informed consent.

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In Sweden, which has a complete register of all ECT treatments in the country, in 2013 the rate of persons treated in that year per 100,000 inhabitants was 41. Almost the same rate had already been present in 1975 with 42 patients per 100,000 inhabitants.

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in 1960. He is reported to have said to his biographer, "Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient." However, the same biographer

679:, about 50% of people relapsed by 12 months following successful initial treatment with ECT, with about 37% relapsing within the first 6 months. About twice as many relapsed with no antidepressants. Most of the evidence for continuation therapy is with 472:

convened a consensus development conference on ECT and concluded that, while ECT was the most controversial treatment in psychiatry and had significant side-effects, it had been shown to be effective for a narrow range of severe psychiatric disorders.

675:), it is associated with a relapse rate of 84%. There is no defined schedule for maintenance ECT, however it is usually started weekly with intervals extended permissibly with the goal of maintaining remission. When ECT is followed by treatment with 902:

If steps are taken to decrease potential risks, ECT is generally accepted to be relatively safe during all trimesters of pregnancy, particularly when compared to pharmacological treatments. Suggested preparation for ECT during pregnancy includes a

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and colleagues found that bilateral ECT left patients with more persistently impaired memory of public events as compared to right unilateral ECT. However, bilateral ECT may be more efficacious than unilateral in the treatment of mood disorders.

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of a seizure, while doses massively above threshold level, especially with bilateral ECT, expose patients to the risk of more severe cognitive impairment without additional therapeutic gains. Seizure threshold is determined by trial and error ("

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is another notable person who has undergone ECT. In his 40s, his depression became so severe that he had to be institutionalized. After exhausting all treatment options, a young resident assigned to his case suggested ECT, which ended up being

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About 70 percent of ECT patients are women. This may be because women are more likely to be diagnosed with depression. Older and more affluent patients are also more likely to receive ECT. The use of ECT is not as common in ethnic minorities.

870:. One published review summarizing the results of questionnaires about subjective memory loss found that between 29% and 55% of respondents believed they experienced long-lasting or permanent memory changes. In 2000, American psychiatrist 1291:

the patient's condition. A patient may not be capable of making the decision (they "lack capacity"), and in that situation ECT can be given if it is appropriate and also if there are no advance directives that prevent the use of ECT.

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after ECT. Other common adverse effects after ECT include headache, jaw soreness, nausea, vomiting and fatigue. These side effects are transient and respond to treatment. There is evidence and rationale to support giving low doses of

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which took effect in 2007, ECT may not generally be given to a patient who has capacity and refuses it, irrespective of his or her detention under the Act. In fact, even if a patient is deemed to lack capacity, if they made a valid

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required the FDA to retrospectively review already existing devices, classify them, and determine whether clinical trials were needed to prove efficacy and safety. The FDA initially classified the devices used to administer ECT as

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A meta-analysis from 2017 found that the death rate of ECT was around 2.1 per 100,000 procedures. A review from 2011 reported an estimate of the mortality rate associated with ECT as less than 1 death per 73,440 treatments.

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to 6 seconds, either from temple to temple (bilateral ECT) or from front to back of one side of the head (unilateral ECT). However, only about 1% of the electrical current crosses the bony skull into the brain because skull

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Because of the backlash noted previously, national institutions reviewed past practices and set new standards. In 1978, the American Psychiatric Association released its first task force report in which new standards for

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studies based on a global data collaboration resulted in a model of temporary disruption of neural circuits followed by augmented neuroplasticity and rewiring. Other brain changes observed after ECT include increased

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Unilateral ECT is thought to cause fewer cognitive effects than bilateral treatment, but is less effective unless administered at higher doses. Most patients in the US and almost all in the UK receive bilateral ECT.

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Ikeji OC, Ohaeri JU, Osahon RO, Agidee RO (1999). "Naturalistic comparative study of outcome and cognitive effects of unmodified electro-convulsive therapy in schizophrenia, mania and severe depression in Nigeria".

7734: 486:, and the expanded role that the procedure has in modern medicine. By 2017, ECT was routinely covered by insurance companies for providing the "biggest bang for the buck" for otherwise intractable cases of severe 1300:

practice guidelines recommend ECT for the treatment of schizophrenia, depressive disorders, and bipolar disorder and in the Chinese literature, ECT is an effective treatment for schizophrenia and mood disorders.

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Blaine JD, Clark SM (1986). "Report of the NIMH-NIH Consensus Development Conference on electroconvulsive therapy--statement of the Consensus Development Panel--statement of the Consensus Development Panel".

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In the early 1940s, in an attempt to reduce the memory disturbance and confusion associated with treatment, two modifications were introduced: the use of unilateral electrode placement and the replacement of

202:. Immediately following treatment, the most common adverse effects are confusion and transient memory loss. Among treatments for severely depressed pregnant women, ECT is one of the least harmful to the 3959:

Gallegos J, Vaidya P, D'Agati D, Jayaram G, Nguyen T, Tripathi A, et al. (June 2012). "Decreasing adverse outcomes of unmodified electroconvulsive therapy: suggestions and possibilities".

5995: 4922: 1566: 225:. The usual course of ECT involves multiple administrations, typically given two or three times per week until the patient no longer has symptoms. ECT is administered under anesthesia with a 4160:

Watts BV, Groft A, Bagian JP, Mills PD (June 2011). "An examination of mortality and other adverse events related to electroconvulsive therapy using a national adverse event report system".

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Sirgiovanni, E, Aruta, A (2020) "The Electroshock Triangle: Disputes about the ECT Apparatus Prototype and its Display in the 1960s, History of Psychiatry. First Published April 20, 2020:

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rate for patients given a round of ECT treatment was 50.9% for those with unipolar depression and 53.2% for those with bipolar depression. Most severely depressed patients respond to ECT.

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Leroy A, Naudet F, Vaiva G, Francis A, Thomas P, Amad A (October 2018). "Is electroconvulsive therapy an evidence-based treatment for catatonia? A systematic review and meta-analysis".

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Penders TM, Lang MC, Pagano JJ, Gooding ZS (December 2013). "Electroconvulsive therapy improves persistent psychosis after repeated use of methylenedioxypyrovalerone ("bath salts")".

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life as well as reduce the risk of re-hospitalization. Efficacy does not depend on depression subtype. With regards to treatment resistant schizophrenia, the response rate is 40–70%.

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education, and training of ECT were documented. Finally, in 2001 the American Psychiatric Association released its latest task force report. This report emphasizes the importance of

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Osler M, Rozing MP, Christensen GT, Andersen PK, Jørgensen MB (April 2018). "Electroconvulsive therapy and risk of dementia in patients with affective disorders: a cohort study".

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Many expert proponents of ECT maintain that the procedure is safe and does not cause brain damage. Dr. Charles Kellner, a prominent ECT researcher and former chief editor of the

6788: 533:, and in conditions where "there is a need for rapid, definitive response because of the severity of a psychiatric or medical condition (e.g., when illness is characterized by 7328: 6584:"FDA In Brief: FDA takes action to ensure regulation of electroconvulsive therapy devices better protects patients, reflects current understanding of safety and effectiveness" 3305:

Dierckx B, Heijnen WT, van den Broek WW, Birkenhäger TK (March 2012). "Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta-analysis".

6583: 3436:"Comparing the effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in the treatment of depression: a systematic review and meta-analysis" 266:

As early as the 16th century, agents to induce seizures were used to treat psychiatric conditions. In 1785, the therapeutic use of seizure induction was documented in the

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Whether psychiatric medications are terminated prior to treatment or maintained, varies. However, drugs that are known to cause toxicity in combination with ECT, such as

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Placement can be bilateral, where the electric current is passed from one side of the brain to the other, or unilateral, in which the current is solely passed across one

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to treat patients with various mental disorders. G.B.C. Duchenne, the mid-19th century "Father of Electrotherapy", said its use was integral to a neurological practice.

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Semkovska M, McLoughlin DM (June 2013). "Measuring retrograde autobiographical amnesia following electroconvulsive therapy: historical perspective and current issues".

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Tørring N, Sanghani SN, Petrides G, Kellner CH, Østergaard SD (May 2017). "The mortality rate of electroconvulsive therapy: a systematic review and pooled analysis".

1519:(FDA) implemented a rule previously drafted in 2016 banning the use of ECT to treat disabilities. This ban specifically had major complications for the controversial 1303:

Although the Chinese government stopped classifying homosexuality as an illness in 2001, electroconvulsive therapy is still used by some establishments as a form of "

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In unilateral ECT, both electrodes are placed on the same side of the patient's head. Unilateral ECT may be used first to minimize side effects such as memory loss.

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of the brain. High-dose unilateral ECT has some cognitive advantages compared to moderate-dose bilateral ECT while showing no difference in antidepressant efficacy.

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Pompili M, Dominici G, Giordano G, Longo L, Serafini G, Lester D, et al. (December 2014). "Electroconvulsive treatment during pregnancy: a systematic review".

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Lisanby SH, Maddox JH, Prudic J, Devanand DP, Sackeim HA (June 2000). "The effects of electroconvulsive therapy on memory of autobiographical and public events".

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DeJong H, Bunton P, Hare DJ (September 2014). "A systematic review of interventions used to treat catatonic symptoms in people with autistic spectrum disorders".

1588:, 1987) emphasized - according to a review from 2008 - "that Hemingway’s serious mental illness and plans for suicide significantly predated his ECT treatments." 7765: 1226:

ECT became popular in the US in the 1940s. At the time, psychiatric hospitals were overrun with patients whom doctors were desperate to treat and cure. Whereas

252:, a device "for giving general electric treatment for psychological effect, in psycho-neurotic cases", according to original photo description. World War I era. 1627:

as the party's vice presidential candidate after it was revealed that he had received electroshock treatment in the past for depression. Presidential nominee

1350:(2005) advises that ECT should be used only with the informed consent of the patient (or their guardian if their incapacity to consent has been established). 651: 7456: 6951: 2790: 387:

ECT soon replaced metrazol therapy all over the world because it was cheaper, less frightening and more convenient. Cerletti and Bini were nominated for a

7309: 2136: 2082:"Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials" 6876: 3266: 7038:

McFarquhar TF, Thompson J (December 2008). "Knowledge and attitudes regarding electroconvulsive therapy among medical students and the general public".

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Murray ED, Buttner N, Price BH (2012). "Depression and Psychosis in Neurological Practice". In Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.).

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UK ECT Review Group (March 2003). "Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis".

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While there are no absolute contraindications for ECT, there is increased risk for patients who have unstable or severe cardiovascular conditions or

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Euba R, Saiz A (2006). "A comparison of the ethnic distribution in the depressed inpatient population and in the electroconvulsive therapy clinic".

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Gbyl K, Videbech P (September 2018). "Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta-analysis".

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Sirgiovanni E, Aruta A (April 23, 2020). "From the Madhouse to the Docu-Museum: The Enigma Surrounding the Cerletti-Bini ECT Apparatus Prototype".

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is more commonly used in private psychiatric hospitals than in public hospitals, and minority patients are underrepresented in the ECT statistics.

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has also been shown to reduce relapse rates. Maintenance ECT may safely continue indefinitely, with no set maximum treatment interval established.

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experienced both insulin coma therapy and ECT (but without the use of anesthesia or muscle relaxants). She wrote about this in her autobiography,

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Neither current nor proposed safeguards for patients are sufficient to ensure informed consent with respect to ECT, at least in England and Wales.

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Philpot M, Treloar A, Gormley N, Gustafson L (March 2002). "Barriers to the use of electroconvulsive therapy in the elderly: a European survey".

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Chanpattana W, Kunigiri G, Kramer BA, Gangadhar BN (2005). "Survey of the practice of electroconvulsive therapy in teaching hospitals in India".

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Matthews AM, Rosenquist PB, McCall WV (September 2016). "Representations of ECT in English-Language Film and Television in the New Millennium".

5917: 4496: 624:

In 2004, a meta-analysis found in terms of efficacy, "a significant superiority of ECT in all comparisons: ECT versus simulated ECT, ECT versus

88: 7785: 6011: 2064: 7579: 7524: 7491: 7212: 7092: 7015: 6405: 3289: 3165: 2950: 1997: 6536:

Teh SP, Helmes E, Drake DG (May 2007). "A Western Australian survey on public attitudes toward and knowledge of electroconvulsive therapy".

771: 655: 501:

studies based on a global data collaboration ECT was suggested to work via a temporary disruption of neural circuits followed by augmented

427: 5174:

Motohashi N, Awata S, Higuchi T (2004). "A questionnaire survey of ECT practice in university hospitals and national hospitals in Japan".

1095:, are either discontinued, a benzodiazepine antagonist is administered at each ECT session, or the ECT treatment is adjusted accordingly. 272:. As to its earliest antecedents one doctor claims 1744 as the dawn of electricity's therapeutic use, as documented in the first issue of 6848: 3539:"Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta-analysis" 2234: 426:

use along with negative depictions of ECT in the mass media led to a marked decline in the use of ECT during the 1950s to the 1970s. The

7408: 5351: 2852:"The Neurobiological Effects of Electroconvulsive Therapy Studied Through Magnetic Resonance: What Have We Learned, and Where Do We Go?" 465: 268: 5630: 4074:

Benson NM, Seiner SJ (2019). "Electroconvulsive Therapy in Children and Adolescents: Clinical Indications and Special Considerations".

1870: 1531:, which uses various methods of ECT. Specifically, it is believed by many that most of the cases at JRC do not require the use of ECT. 778:" to its use. Immediately following treatment, the most common adverse effects are confusion and memory loss. Some patients experience 7760: 6785: 5355: 5100: 4010: 391:

but did not receive one. By 1940, the procedure was introduced to both England and the US. In Germany and Austria, it was promoted by

7336: 1433:. In Scotland, the Mental Health (Care and Treatment) (Scotland) Act 2003 also gives patients with capacity the right to refuse ECT. 7770: 6465: 4658:, Verma AK, Tirumalasetti F, Sackeim HA (July 1991). "Absence of cognitive impairment after more than 100 lifetime ECT treatments". 2574: 1795: 743: 654:(rTMS) for people with treatment-resistant major depressive disorder, ECT relieves depression as shown by reducing the score on the 285: 1700:

Electroconvulsive therapy has been depicted in fiction, including fictional works partly based on true experiences. These include

643:

and antidepressant drugs. This meta-analysis demonstrated a large effect size (high efficacy relative to the mean in terms of the

434:

was routinely given, and that "these now-antiquated practices contributed to the negative portrayal of ECT in the popular media."

7790: 7738: 5288: 1620: 1455: 839: 461: 3873:

Penders TM, Gestring RE, Vilensky DA (November 2012). "Intoxication delirium following use of synthetic cathinone derivatives".

6990: 5425:"Adjunctive psychotropic medications during electroconvulsive therapy in the treatment of depression, mania, and schizophrenia" 1986:

American Psychiatric Association, Committee on Electroconvulsive Therapy, Richard D. Weiner (chairperson), et al. (2001).

1715: 6751:

Lutchman RD, et al. (2001). "Mental health professionals' attitudes towards and knowledge of electroconvulsive therapy".

887:

structural brain pathology have not been supported by decades of methodologically sound research in both humans and animals."

350:

in use at the time. Cerletti, who had been using electric shocks to produce seizures in animal experiments, and his assistant

7116: 4874:"Major Adverse Cardiac Events and Mortality Associated with Electroconvulsive Therapy: A Systematic Review and Meta-analysis" 2721: 2558: 2428: 1275: 335: 71: 2235:"Electricity: a history of its use in the treatment of mental illness in Britain during the second half of the 19th century" 6492: 6421:

Golenkov A, Ungvari GS, Gazdag G (May 2012). "Public attitudes towards electroconvulsive therapy in the Chuvash Republic".

821:

In adolescents, ECT is highly efficient for several psychiatric disorders, with few and relatively benign adverse effects.

754:, whether excited or stuporous. There are also case reports of ECT improving persistent psychotic symptoms associated with 561:

in adults with an intellectual disability, yet findings from a systematic review found this an unestablished intervention.

7287: 6734: 6616: 6310:

Fisher P (December 2012). "Psychological factors related to the experience of and reaction to electroconvulsive therapy".

1446: 1425: 1371: 726:

recommends it only in life-threatening situations or when other treatments have failed and as a second-line treatment for

469: 33: 6901: 6808: 5867: 5473: 384:. It was because of this side effect that patients could not remember the treatments and had no ill feelings toward it. 6152: 3216:

Fitzgerald PB (September 2013). "Non-pharmacological biological treatment approaches to difficult-to-treat depression".

2215: 1516: 1480: 1442: 684: 6687: 993:

The placement of electrodes, as well as the dose and duration of the stimulation is determined on a per-patient basis.

7228:

Healy D, Charlton BG (May 2009). "Electroshock in Zen and the Art of Motorcycle Maintenance--fictional, not factual".

6080: 1749: 1308: 629: 590: 2599: 1256:; schizophrenia was the next most common diagnosis. Sixteen percent were treated without their consent. In 2003, the 396: 299:

In the second half of the 19th century, such efforts were frequent enough in British asylums as to make it notable.

6169:

Tang YL, et al. (Dec 2012). "Electroconvulsive therapy in China: clinical practice and research on efficacy".

4973:"Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses" 347: 7595:

Sienaert P (2016). "Based on a True Story? The Portrayal of ECT in International Movies and Television Programs".

3348:

Pagnin D, de Queiroz V, Pini S, Cassano GB (March 2004). "Efficacy of ECT in depression: a meta-analytic review".

1198:. Changes in sleep architecture due to the induced seizures have also been hypothesized as a mechanism of action. 750:; there is comprehensive research evidence for such practice. It is useful in the case of severe exacerbations of 2899:

Beloucif S (April 2013). "Informed consent for special procedures: electroconvulsive therapy and psychosurgery".

1347: 707: 680: 570: 518: 210: 7681: 1960: 7775: 7020: 5566: 1800: 1098:

A 2009 RCT provides some evidence indicating that concurrent use of some antidepressant improves ECT efficacy.

95: 7130: 7131:"History, power, and electricity: American popular magazine accounts of electroconvulsive therapy, 1940-2005" 6970:"#StopTheShock: The Judge Rotenberg Center, Torture, and How We can Stop It - Autistic Self Advocacy Network" 683:; evidence for relapse prevention with newer antidepressants is lacking. Adjunct maintenance ECT paired with 6823: 6796: 2683:

Friedberg J (September 1977). "Shock treatment, brain damage, and memory loss: a neurological perspective".

1261: 751: 586: 546: 7264:"50 years ago: Sen.Thomas Eagleton discloses electric shock treatments and changes a presidential campaign" 5655:

Reid WH, Keller S, Leatherman M, Mason M (January 1998). "ECT in Texas: 19 months of mandatory reporting".

4600: 3537:

Lambrichts S, Detraux J, Vansteelandt K, Nordenskjöld A, Obbels J, Schrijvers D, et al. (April 2021).

1124: 617:

responded to other medical treatments very differently, both groups responded equally well to ECT. Overall

5352:"Abusive practice of "unmodified" electroshock treatment abolished at main psychiatric facility of Turkey" 4634: 2440:

Rudorfer MV, Henry ME, Sackheim HA (1997). "Electroconvulsive therapy". In Tasman A, Lieberman JA (eds.).

1520: 1420: 1412: 1287: 582: 578: 392: 1161:

Despite decades of research, the exact mechanism of action of ECT remains elusive. A review from 2022 of

438:

described the public's negative perception of ECT as being caused mainly by one movie: "For Big Nurse in

4311:"A randomized controlled trial of brief and ultrabrief pulse right unilateral electroconvulsive therapy" 1888: 1612: 1524: 818:), or who have severe pulmonary conditions, or who are generally at high risk for receiving anesthesia. 811: 7744: 6969: 4738:"Hippocampal volume changes following electroconvulsive therapy: a systematic review and meta-analysis" 1058:

ECT is usually administered three times a week, on alternate days, over a course of two to four weeks.

973: 415:, the muscle-paralysing South American poison, in order to modify the convulsions. The introduction of 2298:

Berrios GE (March 1997). "The scientific origins of electroconvulsive therapy: a conceptual history".

6274: 5914: 5070: 5026:

Prudic J, Olfson M, Sackeim HA (July 2001). "Electro-convulsive therapy practices in the community".

4491: 1691:

but had been told by his doctors that ECT was necessary to treat Reed's mental and behavioral issues.

1663: 1651: 1084: 690: 672: 618: 609:

on the effectiveness of ECT in unipolar and bipolar depression indicated that although patients with

192: 54: 6232: 6008: 2776: 2061: 333:

was held in Switzerland by the Swiss psychiatrist Max Müller. The proceedings were published in the

5784:"Effects of Hesel-coil deep transcranial magnetic stimulation for depression - a systematic review" 5093:

The ECT Handbook: The Third Report of the Royal College of Psychiatrists' Special Committee of ECT.

2945: 2149: 1989:

The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging

911:

medication, uterine tocodynamometry, intravenous hydration, and administration of a nonparticulate

862: 755: 610: 277: 6730:"Information, consent and perceived coercion: patients' perspectives on electroconvulsive therapy" 3842:

Tharyan P, Adams CE (April 2005). Tharyan P (ed.). "Electroconvulsive therapy for schizophrenia".

3263:"Depression in adults: The treatment and management of depression in adults. NICE guidelines CG90" 557:, or life-threatening physical exhaustion associated with mania)." It has also been used to treat 7663: 7620: 7542: 7390: 7063: 6768: 6561: 6446: 6378: 6335: 6265: 6194: 6122: 5975: 5715: 5554: 5405: 5242: 5199: 5140: 5051: 4995: 4953: 4814: 4718: 4655: 4470: 4185: 4142: 4099: 3984: 3941: 3898: 3824: 3781: 3716: 3673: 3576: 3416: 3373: 3330: 3241: 3072: 2924: 2817: 2513: 2323: 2265: 2112: 2043: 1492: 1304: 1052: 904: 848: 843: 788: 767: 766:

Aside from effects in the brain, the general physical risks of ECT are similar to those of brief

644: 614: 574: 522: 404: 381: 370: 330: 303: 199: 198:

Aside from effects on the brain, the general physical risks of ECT are similar to those of brief

1930: 861:

Retrograde amnesia is most marked for events occurring in the weeks or months before treatment.

3799:

Malhi GS, Tanious M, Berk M (December 2012). "Mania: diagnosis and treatment recommendations".

7655: 7612: 7575: 7569: 7530: 7520: 7487: 7382: 7245: 7208: 7161: 7112: 7088: 7055: 6607: 6553: 6504: 6438: 6401: 6370: 6327: 6292: 6186: 6114: 6059: 5967: 5848: 5813: 5764: 5733:

Nordanskog P, Hultén M, Landén M, Lundberg J, von Knorring L, Nordenskjöld A (December 2015).

5707: 5672: 5612: 5536: 5518: 5454: 5397: 5333: 5270: 5234: 5191: 5132: 5096: 5043: 5003: 4945: 4903: 4849: 4806: 4767: 4710: 4675: 4579: 4544: 4462: 4427: 4389: 4340: 4291: 4234: 4177: 4134: 4091: 4056: 4006: 3976: 3933: 3890: 3855: 3816: 3773: 3708: 3665: 3630: 3568: 3519: 3490:"Relapse following successful electroconvulsive therapy for major depression: a meta-analysis" 3467: 3408: 3365: 3322: 3285: 3233: 3198: 3161: 3121: 3064: 3031:

Benevides TW, Shore SM, Andresen ML, Caplan R, Cook B, Gassner DL, et al. (August 2020).

3013: 2916: 2881: 2757: 2727: 2717: 2700: 2662: 2554: 2424: 2402: 2361: 2315: 2273: 2257: 2196: 2104: 2035: 1993: 1777: 1753: 1643: 1473: 1391: 1092: 941: 915:. During ECT, elevation of the pregnant woman's right hip, external fetal cardiac monitoring, 775: 636: 490:, was receiving favorable media coverage, and was being provided in regional medical centers. 374: 281: 83: 5831:

Hermann R, Dorwart R, Hoover C, Brody J (1995). "Variation in ECT use in the United States".

5359: 4603:. Mental Health: A Report of the Surgeon General (Report). Office of the Surgeon General (US) 4023:

Lima NN, Nascimento VB, Peixoto JA, Moreira MM, Neto ML, Almeida JC, et al. (May 2013).

3752:"Guideline for treatment of bipolar disorder by the Japanese Society of Mood Disorders, 2012" 2850:

Ousdal OT, Brancati GE, Kessler U, Erchinger V, Dale AM, Abbott C, et al. (March 2022).

2179:

The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques

7647: 7604: 7512: 7374: 7237: 7153: 7145: 7047: 6760: 6545: 6430: 6398:

Mad in America: bad science, bad medicine, and the enduring mistreatment of the mentally ill

6362: 6319: 6282: 6178: 6106: 6049: 6041: 5959: 5840: 5803: 5795: 5754: 5746: 5699: 5664: 5604: 5593:"How does ECT work? A new explanatory model and suggestions for non-convulsive applications" 5526: 5508: 5444: 5436: 5389: 5323: 5313: 5226: 5183: 5124: 5035: 4987: 4937: 4893: 4885: 4841: 4798: 4757: 4749: 4702: 4667: 4571: 4534: 4526: 4454: 4419: 4379: 4371: 4358:

Kellner CH, Knapp R, Husain MM, Rasmussen K, Sampson S, Cullum M, et al. (March 2010).

4330: 4322: 4281: 4273: 4265: 4224: 4216: 4169: 4126: 4083: 4046: 4036: 3968: 3925: 3882: 3847: 3808: 3763: 3700: 3657: 3620: 3610: 3558: 3550: 3509: 3501: 3457: 3447: 3400: 3357: 3314: 3225: 3190: 3153: 3111: 3103: 3054: 3044: 3005: 2908: 2871: 2863: 2827: 2692: 2652: 2642: 2505: 2392: 2353: 2307: 2249: 2186: 2096: 2027: 1859: 1785: 1752:", which is based on true events, the character of Saman Kaur receives ECT following a deep 1676: 1572: 933: 920: 851:

related to the depression, including problems with memory, may further limit their utility.

727: 514: 483: 358:

in convulsive therapy and, in 1938, experimented for the first time on a person affected by

233: 5735:"Electroconvulsive Therapy in Sweden 2013: Data From the National Quality Register for ECT" 4623:"In Session with Charles H. Kellner, MD: Current Developments in Electroconvulsive Therapy" 4309:

Loo CK, Katalinic N, Smith DJ, Ingram A, Dowling N, Martin D, et al. (December 2014).

1441:

In the US, ECT devices came into existence prior to medical devices being regulated by the

1061: 878:

ECT has not been found to increase the risk of dementia nor cause structural brain damage.

354:

at Sapienza University of Rome developed the idea of using electricity as a substitute for

7554: 7288:"Sherwin Nuland: How electroshock therapy changed me | Talk Subtitles and Transcript" 6792: 6237: 6084: 6015: 5921: 5637: 4500: 2954: 2459: 2068: 1742: 1632: 1628: 1608: 1585: 1451: 1315:

is also known to have been treated with ECT, sometimes without anestheia, most notably by

1088: 962: 908: 867: 676: 502: 289: 226: 175: 7205:

Summary and Analysis of Zen and the Art of Motorcycle Maintenance: An Inquiry into Values

7179: 6637: 6469: 6097:

Duffett R, Lelliott P (May 1998). "Auditing electroconvulsive therapy. The third cycle".

4360:"Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial" 6278: 4254:"Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy" 1654:

also received ECT for many years, beginning as a teenager, before his suicide at age 46.

7516: 7104: 7080: 6933: 6729: 6054: 6029: 5808: 5783: 5759: 5734: 5703: 5531: 5496: 5449: 5424: 5328: 5301: 5230: 4898: 4873: 4762: 4737: 4384: 4359: 4335: 4310: 4286: 4253: 4229: 4204: 4051: 4024: 3625: 3598: 3514: 3489: 3462: 3435: 3194: 3116: 3091: 3059: 3032: 2876: 2851: 2657: 2630: 1581: 1553: 1416: 1009: 784: 487: 423: 6865:

The Mental Health (Care and Treatment) (Scotland) Act 2003, Part 16, sections 237–239.

6366: 5996:

Electro convulsive therapy: survey covering the period from January 2002 to March 2002

5963: 5934: 4575: 4539: 4514: 3404: 407:

with brief pulse. It took many years for brief-pulse equipment to be widely adopted.

365:

It was believed early on that inducing convulsions aided in helping those with severe

7754: 7667: 7624: 6849:"CQC says care for people treated under the Mental Health Act still needs to improve" 6772: 5187: 5115:

Duffett R, Lelliott P (1998). "Auditing electroconvulsive therapy. The third cycle".

4957: 4103: 3902: 3580: 3563: 3538: 3361: 3318: 3245: 3076: 3033:"Interventions to address health outcomes among autistic adults: A systematic review" 2517: 1790: 1671: 1636: 1593: 1575:, an American author, died by suicide in 1961 half a year after ECT treatment at the 1528: 1504: 1265:

individuals with severe depressive illness, catatonia or a prolonged manic episode".

1253: 1195: 1187: 1032: 1015:

Immediately prior to treatment, a patient is given a short-acting anesthetic such as

945: 871: 747: 739: 606: 594: 554: 416: 366: 326: 307: 7394: 7067: 6565: 6382: 6339: 6126: 5979: 5719: 5409: 5203: 5144: 5055: 4818: 4722: 4474: 4189: 4146: 3945: 3828: 3720: 3420: 3377: 3334: 2928: 2327: 2269: 2116: 2047: 76: 17: 6450: 6198: 5497:"Frequency and Duration of Course of ECT Sessions: An Appraisal of Recent Evidence" 5246: 4220: 3988: 3851: 3785: 3677: 2867: 2832: 2805: 1706: 1701: 1316: 1183: 1179: 1162: 1016: 982: 693:

has also been found to reduce the risk of relapse, especially in younger patients.

498: 343: 6919: 5799: 4872:

Duma A, Maleczek M, Panjikaran B, Herkner H, Karrison T, Nagele P (January 2019).

4252:

McClintock SM, Choi J, Deng ZD, Appelbaum LG, Krystal AD, Lisanby SH (June 2014).

1206:

As of 2001, it was estimated that about one million people received ECT annually.

710:

who have catatonia, there is little published evidence about the efficacy of ECT.

127: 48: 7651: 7481: 7051: 6323: 6182: 6153:"Additional safeguards for ECT introduced in new s58A – Mental Health Law Online" 5750: 5513: 5440: 5393: 4889: 4458: 4269: 4173: 4087: 3972: 3929: 3886: 3738:

Guidance on the use of electroconvulsive therapy. NICE technology appraisals TA59

3284:. Vol. 1 (6th ed.). Philadelphia: Elsevier/Saunders. pp. 114–115. 3090:

Lipsman N, Sankar T, Downar J, Kennedy SH, Lozano AM, Giacobbe P (January 2014).

2912: 2031: 1987: 430:

stated there were problems with electroshock therapy in the initial years before

339:

and, within three years, cardiazol convulsive therapy was being used worldwide.

284:

wrote that an electrostatic machine cured "a woman of hysterical fits." By 1801,

101: 6512: 5950:

Pippard J, Ellam L (1981). "Electroconvulsion treatment in Great Britain 1980".

5073:. Royal College of Psychiatrists' Special Committee on ECT and related treatment 4787:"The management of mood disorders in pregnancy: alternatives to antidepressants" 2806:"A case of schizophrenia successfully treated by m-ECT using 'long' brief pulse" 1658: 1576: 1312: 1268:

The guidance received a mixed reception. It was welcomed by an editorial in the

1171: 1167: 815: 534: 388: 187: 121: 7509:

Literature, Neurology, and Neuroscience: Neurological and Psychiatric Disorders

7365:

the occasion, I wore my schizophrenic fancy dress" - the life of Janet Frame".

7241: 6724: 6722: 6720: 5782:

Nordenskjöld A, Mårtensson B, Pettersson A, Heintz E, Landén M (October 2016).

5608: 4753: 2397: 2380: 2311: 1771: 1674:

wrote about her experience with memory loss after ECT treatments in her memoir

1390:

Procedures for involuntary ECT vary from country to country depending on local

7608: 6045: 5875: 5039: 4941: 4802: 4530: 4423: 4375: 3812: 3704: 3661: 2509: 2191: 2174: 2100: 1869:(Second ed.). Chichester: John Wiley & Sons Ltd. pp. 1865–1901. 1767: 1731: 1688: 1227: 1028: 916: 796: 628:, ECT versus antidepressants in general, ECT versus tricyclics and ECT versus 431: 351: 171: 163: 7378: 6549: 6434: 6287: 6260: 5592: 5522: 5318: 5007: 4999: 3615: 3049: 1366:

found that about fifty percent of psychiatrists and nurses agreed with them.

1260:, a government body which was set up to standardize treatment throughout the 182:

are applied externally to the patient's head, resulting in approximately 800

114: 6676: 4991: 4041: 1721: 1711: 1540: 1500: 1191: 1024: 957: 803: 702: 538: 526: 450: 342:

The ECT procedure was first conducted in 1938 by Italian neuro-psychiatrist

293: 244: 222: 7747:– information from mental health charity The Royal College of Psychiatrists 7659: 7616: 7534: 7434: 7386: 7249: 7165: 7059: 6764: 6557: 6508: 6442: 6374: 6331: 6296: 6190: 6077: 6063: 5817: 5768: 5711: 5616: 5540: 5458: 5401: 5337: 5274: 5238: 5195: 5047: 4949: 4907: 4832:

Miller LJ (May 1994). "Use of electroconvulsive therapy during pregnancy".

4810: 4771: 4714: 4583: 4548: 4466: 4431: 4393: 4344: 4295: 4238: 4181: 4138: 4095: 4060: 3980: 3937: 3894: 3859: 3820: 3777: 3712: 3669: 3634: 3572: 3523: 3471: 3412: 3369: 3326: 3237: 3202: 3125: 3068: 3017: 2920: 2885: 2791:"Electroconvulsive therapy: How modern techniques improve patient outcomes" 2777:"This mental health treatment isn't barbaric, it 'totally changed my life'" 2731: 2696: 2666: 2534: 2406: 2357: 2319: 2200: 2108: 2039: 6118: 6110: 5971: 5852: 5844: 5676: 5380:

Narang P, Swenson A, Lippmann S (March 2019). "Neuroimaging Before ECT?".

5136: 5128: 4853: 4679: 4671: 4326: 3452: 3157: 3009: 2761: 2365: 2261: 2253: 7157: 5668: 3505: 2996:

Espinoza RT, Kellner CH (17 February 2022). "Electroconvulsive Therapy".

2704: 2484:

The Great Physiodynamic Therapies in Psychiatry: an historical appraisal.

2344:

Fink M (September 1984). "Meduna and the origins of convulsive therapy".

1683: 1616: 1549: 1430: 1175: 1036: 1020: 937: 792: 550: 359: 355: 319: 311: 302:

Convulsive therapy was introduced in 1934 by Hungarian neuropsychiatrist

27:

Medical procedure in which electrical current is passed through the brain

6934:"Electroconvulsive Therapy (ECT) Service | Treatment at McLean Hospital" 4845: 4515:"Patients' perspectives on electroconvulsive therapy: systematic review" 3737: 3597:

Sienaert P, Dhossche DM, Vancampfort D, De Hert M, Gazdag G (Dec 2014).

3262: 3229: 3107: 1491:

Many mental health facilities offer ECT for specific diagnoses, such as

1132: 742:, but in North America and Western Europe it is invariably used only in 322:(cardiazol). Meduna is thought to be the father of convulsive therapy. 186:

of direct current passing between the electrodes, for a duration of 100

7149: 6612: 6493:"Electroconvulsive therapy in New Zealand: terrifying or electrifying?" 6233:"This Man Was Sectioned in China for Being Gay. Now He's Fighting Back" 4706: 4277: 4130: 3554: 1757: 1270: 1142: 978: 966: 912: 855: 842:(APA) report in 2001 acknowledges: "In some patients the recovery from 779: 640: 625: 478: 315: 183: 167: 109: 3768: 3751: 2631:"Contemporary use and practice of electroconvulsive therapy worldwide" 137: 6261:"China Reins in Wilder Impulses in Treatment of 'Internet Addiction'" 2175:"Giovanni Aldini: from animal electricity to human brain stimulation" 1734:

as an orderly at a mental health facility in Menlo Park, California.

1479:

Similarly, ECT is also banned on children under the age of 12 in the

986: 807: 558: 542: 412: 218: 6078:

Appraisal of electroconvulsive therapy: decision of the appeal panel

5570: 4786: 3092:"Neuromodulation for treatment-refractory major depressive disorder" 2647: 2381:"How does electroconvulsive therapy work? Theories on its mechanism" 1415:

allowed the use of ECT on detained patients whether or not they had

7507:

Kellner C (2013). "Electroconvulsive Therapy (ECT) in Literature".

6214:"Chinese hospitals still offering gay 'cure' therapy, film reveals" 4025:"Electroconvulsive therapy use in adolescents: a systematic review" 7571:

Narrative Prosthesis: Disability and the Dependencies of Discourse

6677:"The Scottish ECT Accreditation Network (SEÁN) Annual Report 2009" 5474:"Response Predictors in ECT: A discussion about Seizure Threshold" 2822: 1496: 1131: 1123: 1060: 972: 956: 719: 530: 243: 214: 203: 6902:"Electroshock therapy on under-14s banned in WA after law passes" 1992:(2nd ed.). Washington, DC: American Psychiatric Publishing. 7457:"Lou Reed's Sister Sets the Record Straight About His Childhood" 6599:"The FDA Advisory Panel on the Reclassification of ECT Devices: 4513:

Rose D, Fleischmann P, Wykes T, Leese M, Bindman J (June 2003).

2947:

WHO Resource Book on Mental Health, Human Rights and Legislation

1545: 1319:. The practice was banned in 2009 after news on Yang broke out. 1146: 723: 179: 7511:. Progress in Brain Research. Vol. 206. pp. 219–228. 6400:(Rev. pbk. ed.). New York: Basic Books. pp. 102–106. 5897:"Electroconvulsive Therapy in Children | Psychology Today" 4490:

Benbow, SM (2004) "Adverse effects of ECT". In AIF Scott (ed.)

3148:

Tasman A, Kay J, Lieberman JA, First MB, Riba MB, eds. (2015).

1539:

A questionnaire survey of 379 members of the general public in

4742:

Biological Psychiatry. Cognitive Neuroscience and Neuroimaging

1745:

is typically interpreted as depicting someone undergoing ECT.

1048: 1044: 2691:(9). American Psychiatric Association Publishing: 1010–1014. 1730:; Kesey's novel is a direct product of his time working the 1252:

over 65 years of age. Eighty-one percent had a diagnosis of

1040:

abolished in Turkey's largest psychiatric hospital in 2008.

932:

ECT can cause a lack of blood flow and oxygen to the heart,

7409:"Review/Film; 3 Novels Are Adapted For 'Angel at My Table'" 4205:"Deep brain stimulation for treatment-resistant depression" 1567:

List of people who have undergone electroconvulsive therapy

1278:

launched an unsuccessful appeal. The NICE guidance, as the

647:) for ECT versus placebo, and versus antidepressant drugs. 7735:

Position Statement on Electroconvulsive Therapy (ECT) 2015

7310:"Sherwin B. Nuland, Author of 'How We Die,' is Dead at 83" 5302:"Time to face new realities; mental health care bill-2013" 4923:"Depression: why drugs and electricity are not the answer" 2478:

Cerletti, U (1956). "Electroshock therapy". In AM Sackler

847:

application to people with depressive disorders, who have

258:

History of electroconvulsive therapy in the United Kingdom

7707:"The Real People and Cast of Mr Bates vs The Post Office" 7033: 7031: 3650:

European Archives of Psychiatry and Clinical Neuroscience

2553:. Melbourne: Blackwell Scientific Publications, 190–208. 1149:, and the current flows for between one and six seconds. 981:

and used for example at the Asyl psychiatric hospital in

718:

ECT is used to treat people who have severe or prolonged

701:

ECT is generally a second-line treatment for people with

314:

were antagonistic disorders, induced seizures first with

262:

History of electroconvulsive therapy in the United States

7329:"The Lost Years & Last Days of David Foster Wallace" 6877:"Time Is Now to Support the ECT Reclassification Effort" 4503:

London: The Royal College of Psychiatrists, pp. 170–174.

3282:

Bradley's Neurology in Clinical Practice: Expert Consult

2421:

Geschichte der medikamentösen Therapie der Schizophrenie

658:

by about 15 points, while rTMS reduced it by 9 points.

6636:

Duff Wilson for the New York Times. January 28, 2011

5160:

Lock, T (1995). "Stimulus dosing". In C Freeman (ed.)

2629:

Leiknes KA, Jarosh-von Schweder L, Høie B (May 2012).

346:

and rapidly replaced less safe and effective forms of

6836:

In Place of Fear? eleventh biennial report, 2003–2005

4003:

Electroconvulsive Therapy in Children and Adolescents

3488:

Jelovac A, Kolshus E, McLoughlin DM (November 2013).

2137:

A History of Mental Institutions in the United States

2080:

Kolshus E, Jelovac A, McLoughlin DM (February 2017).

838:

Cognitive impairment sometimes occurs after ECT. The

7016:"UN Calls Shock Treatment at Mass. School 'Torture'" 5935:"Electroconvulsive therapy: Evidence and Challenges" 5289:

Electroshocks for mentally ill patients to be banned

4315:

The International Journal of Neuropsychopharmacology

3189:(1). Ovid Technologies (Wolters Kluwer Health): 51. 2216:"An Historical Review of Electro Convulsive Therapy" 1194:

neurotransmitters and increased neurogenesis in the

7483:

Please Kill Me: The Uncensored Oral History of Punk

5553:Corinne Slusher for MedScape. Updated: Jan 6, 2012 2624: 2622: 2620: 2575:"Federal Report Praising Electroshock Stirs Uproar" 2139:

which says electrostatic machines were used in 1773

1667:(1984), which was later adapted into a film (1990). 1065:

An illustration depicting electroconvulsive therapy

120: 108: 94: 82: 70: 62: 41: 32:"Electroshock" redirects here. For other uses, see 7356: 7354: 1981: 1979: 1977: 1975: 1973: 1971: 1969: 1403:especially when other treatments are ineffective. 774:'s report says that there are "no absolute health 445:it was a tool of terror, and, in the public mind, 6714:, 5th edition. London: Sweet and Maxwell, p. 225. 5091:Royal College of Psychiatrists. Council Report. 3599:"A clinical review of the treatment of catatonia" 3483: 3481: 3181:Bolwig TG (March 2005). "First-line use of ECT". 2991: 2989: 2987: 2985: 2983: 1258:National Institute for Health and Care Excellence 1141:the electrical stimulus used in ECT is about 800 738:ECT is widely used worldwide in the treatment of 6728:Rose D, Wykes T, Bindman J, Fleischmann P (2005) 6212:Graham-Harrison E, Connaire S (8 October 2015). 5164:. London: Royal College of Psychiatrists, 72–87. 3750:Kanba S, Kato T, Terao T, Yamada K (July 2013). 3143: 3141: 3139: 3137: 3135: 2981: 2979: 2977: 2975: 2973: 2971: 2969: 2967: 2965: 2963: 2810:International Journal of Case Reports and Images 2013: 2011: 2009: 961:Electroconvulsive therapy machine on display at 799:, to patients to reduce adverse effects of ECT. 5991: 5989: 5868:"Patients often aren't informed of full danger" 4867: 4865: 4863: 4736:Wilkinson ST, Sanacora G, Bloch MH (May 2017). 4405: 4403: 3732: 3730: 3592: 3590: 2339: 2337: 1459:major depressive disorder or bipolar disorder. 1378: 1170:volume in the frontolimbic areas including the 195:is about 100 times higher than skin impedance. 174:) is electrically induced to manage refractory 6582:US Food and Drug Administration (2018-12-21). 6538:The International Journal of Social Psychiatry 6423:The International Journal of Social Psychiatry 5287:Teena Thacker for Indian Express. Mar 23 2011 4971:Read J, Kirsch I, McGrath L (1 October 2019). 3875:The American Journal of Drug and Alcohol Abuse 3152:. Chichester, UK: John Wiley & Sons, Ltd. 2845: 2843: 2568: 2566: 1932:Mental Health: A Report of the Surgeon General 1635:, and later went on to lose by a landslide to 7574:. University of Michigan Press. p. 174. 6651:"FDA Regulation of ECT Devices in Transition" 3693:Journal of Autism and Developmental Disorders 924:the patient's capacity for informed consent. 635:In 2003, The UK ECT Review Group published a 453:'s novel: dangerous, inhumane and overused". 449:has retained the tarnished image given it by 8: 6851:. Care Quality Commission. 8 December 2011. 6820:The Mental Health Act 1983 (updated version) 6786:The Mental Health Act 1983 (updated version) 5021: 5019: 5017: 4203:Holtzheimer PE, Mayberg HS (December 2010). 2600:"The Quiet Comeback of Electroshock Therapy" 2460:"The history of shock therapy in psychiatry" 2453: 2451: 2060:Margarita Tartakovsky (2012) Psych Central. 1955: 1953: 1951: 1949: 1947: 1945: 1943: 1941: 652:repetitive transcranial magnetic stimulation 380:A positive side effect to the treatment was 325:In 1937, the first international meeting on 6809:ECT: Your rights about consent to treatment 6638:F.D.A. Panel Is Split on Electroshock Risks 3844:The Cochrane Database of Systematic Reviews 3257: 3255: 1865:. In Tasman A, Kay J, Lieberman JA (eds.). 1853: 1851: 1849: 1847: 1845: 1843: 1841: 1839: 1837: 1835: 460:The 1970s saw the publication of the first 5495:Thirthalli J, Naik SS, Kunigiri G (2020). 5476:. British Journal of Medical Practitioners 5110: 5108: 4595: 4593: 3267:National Institute for Clinical Excellence 2940: 2938: 2804:Hiroaki I, Hirohiko H, Masanari I (2012). 2549:Kiloh, LG, Smith, JS, Johnson, GF (1988). 1858:Rudorfer MV, Henry ME, Sackeim HA (2003). 1833: 1831: 1829: 1827: 1825: 1823: 1821: 1819: 1817: 1815: 1642:American surgeon and award-winning author 47: 6468:. New York State Assembly. Archived from 6464:Committee on Mental Health (March 2002). 6286: 6053: 5807: 5758: 5530: 5512: 5472:Madhavan Seshadri, Nadeem Z Mazi-Kotwal. 5448: 5327: 5317: 4897: 4761: 4538: 4486: 4484: 4383: 4334: 4285: 4228: 4050: 4040: 3767: 3624: 3614: 3562: 3513: 3461: 3451: 3115: 3058: 3048: 2875: 2831: 2821: 2714:Electroshock: its brain-disabling effects 2656: 2646: 2396: 2233:Beveridge AW, Renvoize EB (August 1988). 2190: 1600:Zen and the Art of Motorcycle Maintenance 209:ECT is often used as an intervention for 6834:The Mental Health Act Commission (2005) 6164: 6162: 5650: 5648: 5646: 5501:Indian Journal of Psychological Medicine 2545: 2543: 2535:https://doi.org/10.1177/0957154X20916147 1625:1972 United States Presidential Election 7361:Lim X, Galletly C (October 2019). ""To 6675:Fergusson G, et al., eds. (2009). 6531: 6529: 6139:Royal College of Psychiatrists (2017). 5156: 5154: 4980:Ethical Human Psychology and Psychiatry 4001:Neera Ghaziuddin, Garry Walter (eds.): 1811: 369:but later found to be most useful with 7682:"Electroconvulsive Therapy Is Torture" 7550: 7540: 7450: 7448: 6577: 6575: 5640:for information about ECT in Slovenia. 4785:Richards EM, Payne JL (October 2013). 1584:, 1966) and also a second biographer ( 746:when symptoms show little response to 38: 7435:"Wishful Drinking with Carrie Fisher" 6466:"Report on Electroconvulsive Therapy" 3756:Psychiatry and Clinical Neurosciences 2529: 2527: 1597:treatment he discusses in his novel, 1419:to consent to it. However, following 1411:Until 2007 in England and Wales, the 854:The acute effects of ECT can include 166:treatment during which a generalized 7: 7766:Human subject research in psychiatry 7415:. 21 May 1991. Section C, p. 15 5423:Haskett RF, Loo C (September 2010). 1925: 1923: 1921: 1919: 1917: 1915: 1128:Vintage ECT machine from before 1960 1035:(succinylcholine), and occasionally 656:Hamilton Rating Scale for Depression 7087:. New York: Macmillan, pp 547–550. 5933:Fink, M. & Taylor, A.M. (2007) 4834:Hospital & Community Psychiatry 639:and meta-analysis comparing ECT to 466:National Institute of Mental Health 280:was documented eleven years later. 269:London Medical and Surgical Journal 133: 7517:10.1016/B978-0-444-63364-4.00029-6 7129:Hirshbein L, Sarvananda S (2008). 6684:Scottish ECT Accreditation Network 5704:10.1097/01.yct.0000235928.39279.52 5231:10.1097/01.yct.0000166634.73555.e6 4660:The American Journal of Psychiatry 4209:The American Journal of Psychiatry 3195:10.1097/01.yct.0000158271.45828.76 2944:World Health Organisation (2005). 2685:The American Journal of Psychiatry 2346:The American Journal of Psychiatry 2150:"Lind, James (1736–1812) on JSTOR" 2020:Expert Review of Neurotherapeutics 907:, discontinuation of nonessential 513:ECT is used, where possible, with 25: 7327:Lipsky, Dave (October 30, 2008). 7109:Papa Hemingway: A Personal Memoir 6952:"Electroconvulsive Therapy (ECT)" 6855:from the original on 21 May 2015. 6099:The British Journal of Psychiatry 5915:Electroconvulsive therapy reports 5913:Texas Department of State (2002) 5555:Electroconvulsive Therapy Machine 4921:Read J, Moncrieff J (June 2022). 4493:The ECT Handbook, second edition. 4364:The British Journal of Psychiatry 4005:, Oxford University Press, 2013, 3440:Depression Research and Treatment 2901:Current Opinion in Anesthesiology 2551:Physical Treatments in Psychiatry 2242:The British Journal of Psychiatry 1796:Transcranial magnetic stimulation 744:treatment resistant schizophrenia 397:Museum of the History of Medicine 7739:American Psychiatric Association 6881:American Psychiatric Association 6028:Carney S, Geddes J (June 2003). 5188:10.1097/00124509-200403000-00005 3362:10.1097/00124509-200403000-00004 3319:10.1111/j.1399-5618.2012.00997.x 3218:The Medical Journal of Australia 2486:New York: Hoeber-Harper, 91–120. 2126:from the original on 2021-06-16. 1876:from the original on 2007-08-10. 1770: 1741:The song “The Mind Electric” by 1704:'s semi-autobiographical novel, 1544:A sample of the general public, 1456:American Psychiatric Association 1055:are monitored during treatment. 840:American Psychiatric Association 462:American Psychiatric Association 7781:Physical psychiatric treatments 7568:Mitchell DT, Snyder SL (2000). 6807:Care Quality Commission (2010) 6693:from the original on 2011-04-29 6497:The New Zealand Medical Journal 6009:Electroconvulsive therapy (ECT) 5356:Disabled Peoples' International 2998:New England Journal of Medicine 2220:Jefferson Journal of Psychiatry 1901:from the original on 2022-02-18 1727:One Flew Over the Cuckoo's Nest 441:One Flew Over the Cuckoo's Nest 306:who, believing mistakenly that 6231:Hannah Beech (June 13, 2016). 4695:Acta Psychiatrica Scandinavica 4412:Archives of General Psychiatry 4221:10.1176/appi.ajp.2010.10010141 4119:Acta Psychiatrica Scandinavica 3852:10.1002/14651858.CD000076.pub2 3543:Acta Psychiatrica Scandinavica 2868:10.1016/j.biopsych.2021.05.023 2833:10.5348/ijcri-2012-07-147-CR-8 2385:Canadian Journal of Psychiatry 1369:A 2005 study published in the 1276:Royal College of Psychiatrists 1145:and has up to several hundred 814:(for instance, due to a solid 336:American Journal of Psychiatry 1: 7786:Treatment of bipolar disorder 6984:"US Report and Urgent Appeal" 6920:"Brutal Rise in Electroshock" 6838:, 236. The Stationery Office. 6735:British Journal of Psychiatry 6367:10.1016/S0924-9338(02)00620-X 5964:10.1016/s0140-6736(81)90602-4 5800:10.3109/08039488.2016.1166263 4576:10.1016/S2215-0366(18)30056-7 3740:. Published date: April 2003 3405:10.1016/S0140-6736(03)12705-5 1447:Medical Device Regulation Act 1372:British Journal of Psychiatry 919:, and avoidance of excessive 470:National Institutes of Health 34:Electroshock (disambiguation) 7652:10.1097/YCT.0000000000000312 7052:10.1097/YCT.0b013e318168be4a 6324:10.3109/09638237.2012.734656 6183:10.1097/YCT.0b013e31825957b1 5940:Vol. 298 No. 3, pp. 330–332. 5788:Nordic Journal of Psychiatry 5751:10.1097/YCT.0000000000000243 5631:Slovenian government website 5514:10.4103/IJPSYM.IJPSYM_410_19 5441:10.1097/YCT.0b013e3181eee13f 5394:10.1097/YCT.0000000000000515 5306:Indian Journal of Psychiatry 4890:10.1097/ALN.0000000000002488 4459:10.1097/YCT.0b013e318279c2c9 4270:10.1097/YCT.0000000000000137 4174:10.1097/YCT.0b013e3181f6d17f 4088:10.1097/HRP.0000000000000236 4076:Harvard Review of Psychiatry 4029:Annals of General Psychiatry 3973:10.1097/YCT.0b013e3182359314 3930:10.1097/YCT.0b013e3182887bc2 3887:10.3109/00952990.2012.694535 2913:10.1097/ACO.0b013e32835e7380 2062:5 Outdated Beliefs About ECT 2032:10.1586/14737175.2014.972373 1517:Food and Drug Administration 1481:Australian Capital Territory 1443:Food and Drug Administration 1031:, a muscle relaxant such as 685:cognitive behavioral therapy 630:monoamine oxidase inhibitors 7480:McNeil L, McCain G (2006). 6030:"Electroconvulsive therapy" 5095:RCPsych Publications, 2005 3434:Micallef-Trigona B (2014). 2750:Psychopharmacology Bulletin 1889:"Electroconvulsive Therapy" 1860:"Electroconvulsive therapy" 1750:Mr Bates vs The Post Office 1311:(or general unruliness) in 989:from the 1960s to the 1980s 756:stimulant-induced psychosis 591:arteriovenous malformations 57:(EEG) in a modern ECT suite 7807: 7290:. TED.com. 30 October 2007 7242:10.1016/j.mehy.2008.12.026 6791:December 26, 2011, at the 6018:. Retrieved on 2007-12-29. 5609:10.1016/j.mehy.2020.110337 4754:10.1016/j.bpsc.2017.01.011 4633:(3): 34–37. Archived from 3801:Current Psychiatry Reports 2398:10.1177/070674371105600104 2379:Bolwig TG (January 2011). 2312:10.1177/0957154X9700802908 2173:Parent A (November 2004). 1748:In the television series " 1564: 1079:Concurrent pharmacotherapy 882:Effects on brain structure 806:; who have recently had a 787:or otherwise low doses of 255: 53:MECTA spECTrum 5000Q with 31: 7761:Electroconvulsive therapy 7609:10.1016/j.brs.2016.07.005 6597:Kellner CH (2012-07-05). 6046:10.1136/bmj.326.7403.1343 5040:10.1017/S0033291701003750 4942:10.1017/S0033291721005031 4803:10.1017/S1092852913000151 4531:10.1136/bmj.326.7403.1363 4424:10.1001/archpsyc.57.6.581 4376:10.1192/bjp.bp.109.066183 3813:10.1007/s11920-012-0324-5 3705:10.1007/s10803-014-2085-y 3662:10.1007/s00406-017-0819-5 3564:10067/1751810151162165141 2510:10.1163/18253911-03501013 2192:10.1017/s0317167100003851 2101:10.1017/S0033291716002737 1452:Class III medical devices 1348:World Health Organization 1070:Neuroimaging prior to ECT 708:autism spectrum disorders 681:tricyclic antidepressants 571:major depressive disorder 565:Major depressive disorder 519:major depressive disorder 497:In a review from 2022 of 211:major depressive disorder 148:Electroconvulsive therapy 134: 46: 42:Electroconvulsive therapy 7771:Psychiatry controversies 7379:10.1177/1039856219839489 7308:Gellene D (2014-03-04). 6753:Journal of Mental Health 6712:Mental Health Act Manual 6655:Clinical Psychiatry News 6550:10.1177/0020764006074522 6435:10.1177/0020764010394282 6312:Journal of Mental Health 6288:10.1126/science.324_1630 5866:Cauchon D (1995-12-06). 5319:10.4103/0019-5545.117129 4793:(Submitted manuscript). 4621:Sussman N (March 2007). 3616:10.3389/fpsyt.2014.00181 3050:10.1177/1362361320913664 2598:Goleman D (1990-08-02). 1929:Surgeon General (1999). 1801:Magnetic seizure therapy 1087:, are discontinued, and 276:. Treatment and cure of 274:Electricity and Medicine 7791:Treatment of depression 7455:Weiner J (2016-04-10). 7367:Australasian Psychiatry 6824:Care Quality Commission 6797:Care Quality Commission 6601:Unjustified Ambivalence 6491:Melding P (July 2006). 5998:. Department of Health. 5901:www.psychologytoday.com 4992:10.1891/EHPP-D-19-00014 4042:10.1186/1744-859X-12-17 3603:Frontiers in Psychiatry 3494:Neuropsychopharmacology 2775:Dutton A (2017-02-18). 1887:Solano J (2009-04-20). 1619:, was dropped from the 1280:British Medical Journal 1271:British Medical Journal 1262:National Health Service 977:ECT device produced by 863:Anterograde memory loss 752:catatonic schizophrenia 547:psychomotor retardation 517:in treatment-resistant 178:. Typically, 70 to 120 7085:Hemingway: A Biography 6938:www.mcleanhospital.org 6765:10.1080/09638230124779 6259:Stone R (2009-07-26). 4930:Psychological Medicine 2716:. New York: Springer. 2697:10.1176/ajp.134.9.1010 2573:Goode E (1999-10-06). 2358:10.1176/ajp.141.9.1034 2089:Psychological Medicine 1521:Judge Rotenberg Center 1511:Judge Rotenberg Center 1413:Mental Health Act 1983 1383: 1288:Mental Health Act 2007 1137: 1129: 1066: 990: 970: 529:, prolonged or severe 525:, treatment-resistant 393:Friedrich Meggendorfer 253: 55:electroencephalography 7180:"All About Heaven \e" 6956:Mental Health America 6822:Part IV, Section 62. 6795:Part IV, Section 58. 6111:10.1192/bjp.172.5.401 5845:10.1176/ajp.152.6.869 5129:10.1192/bjp.172.5.401 4672:10.1176/ajp.148.7.929 4564:The Lancet Psychiatry 3313:(2). Wiley: 146–150. 3158:10.1002/9781118753378 3010:10.1056/NEJMra2034954 2856:Biological Psychiatry 2444:. pp. 1535–1556. 2300:History of Psychiatry 2254:10.1192/bjp.153.2.157 1961:FDA Executive Summary 1613:United States Senator 1135: 1127: 1091:, which increase the 1064: 976: 960: 812:intracranial pressure 810:; who have increased 422:The steady growth of 348:biological treatments 256:Further information: 247: 7203:Worth Books (2017). 5669:10.4088/JCP.v59n0103 5591:Tsoukalas I (2020). 5071:"Information on ECT" 3506:10.1038/npp.2013.149 2306:(29 pt 1): 105–119. 2279:on 23 September 2015 1664:An Angel at My Table 1652:David Foster Wallace 928:Effects on the heart 898:Effects in pregnancy 866:memory, rather than 834:Cognitive impairment 671:antidepressants and 278:hysterical blindness 156:electroshock therapy 66:Electroshock therapy 18:Electroshock therapy 7207:. Open Road Media. 6875:Levin S, Binder R. 6396:Whitaker R (2010). 6355:European Psychiatry 6279:2009Sci...324.1630S 6273:(5935): 1630–1631. 6040:(7403): 1343–1344. 5958:(8256): 1160–1161. 5567:"Ectron: Our story" 4846:10.1176/ps.45.5.444 4327:10.1093/ijnp/pyu045 3453:10.1155/2014/135049 3230:10.5694/mja12.10509 3108:10.1503/cmaj.121317 2712:Breggin PR (1979). 1657:New Zealand author 1323:Society and culture 1157:Mechanism of action 1053:blood oxygen levels 789:general anesthetics 611:unipolar depression 587:developmental delay 583:Huntington's chorea 579:Parkinson's disease 371:affective disorders 7640:The Journal of ECT 7413:The New York Times 7314:The New York Times 7230:Medical Hypotheses 7184:allaboutheaven.org 7150:10.1002/jhbs.20283 7040:The Journal of ECT 6922:. 4 December 2017. 6908:. 17 October 2014. 6083:2007-05-21 at the 6014:2008-09-08 at the 5920:2007-08-10 at the 5739:The Journal of ECT 5636:2007-08-08 at the 5597:Medical Hypotheses 5429:The Journal of ECT 5382:The Journal of ECT 4707:10.1111/acps.12884 4627:Primary Psychiatry 4499:2012-04-21 at the 4447:The Journal of ECT 4258:The Journal of ECT 4162:The Journal of ECT 4131:10.1111/acps.12721 3961:The Journal of ECT 3918:The Journal of ECT 3555:10.1111/acps.13277 3350:The Journal of ECT 3183:The Journal of ECT 2953:2006-12-06 at the 2635:Brain and Behavior 2604:The New York Times 2579:The New York Times 2067:2013-08-08 at the 1696:Fictional examples 1631:replaced him with 1493:chronic depression 1392:mental health laws 1309:Internet addiction 1305:conversion therapy 1138: 1136:Modern ECT machine 1130: 1067: 991: 971: 936:, and "persistent 905:pelvic examination 849:cognitive deficits 844:retrograde amnesia 772:US Surgeon General 768:general anesthesia 645:standard deviation 615:bipolar depression 575:multiple sclerosis 523:bipolar depression 436:The New York Times 405:sinusoidal current 382:retrograde amnesia 331:convulsive therapy 304:Ladislas J. Meduna 254: 200:general anesthesia 170:(without muscular 7737: – from the 7597:Brain Stimulation 7581:978-0-472-06748-0 7526:978-0-444-63364-4 7493:978-0-8021-4264-1 7214:978-1-5040-4641-1 7093:978-0-333-42126-0 6608:Psychiatric Times 6407:978-0-465-02014-0 5657:J Clin Psychiatry 4215:(12): 1437–1444. 3769:10.1111/pcn.12060 3500:(12): 2467–2474. 3399:(9360): 799–808. 3307:Bipolar Disorders 3291:978-1-4377-0434-1 3167:978-1-118-75337-8 2026:(12): 1377–1390. 1999:978-0-89042-206-9 1778:Psychiatry portal 1644:Sherwin B. Nuland 1621:Democratic ticket 1535:Public perception 1474:Western Australia 1190:lobes, increased 1093:seizure threshold 942:systematic review 776:contraindications 637:systematic review 282:Benjamin Franklin 145: 144: 110:OPS-301 code 16:(Redirected from 7798: 7723: 7722: 7720: 7718: 7703: 7697: 7696: 7694: 7693: 7678: 7672: 7671: 7635: 7629: 7628: 7592: 7586: 7585: 7565: 7559: 7558: 7552: 7548: 7546: 7538: 7504: 7498: 7497: 7477: 7471: 7470: 7468: 7467: 7452: 7443: 7442: 7431: 7425: 7424: 7422: 7420: 7405: 7399: 7398: 7358: 7349: 7348: 7346: 7344: 7335:. Archived from 7324: 7318: 7317: 7305: 7299: 7298: 7296: 7295: 7284: 7278: 7277: 7275: 7274: 7260: 7254: 7253: 7225: 7219: 7218: 7200: 7194: 7193: 7191: 7190: 7176: 7170: 7169: 7138:J Hist Behav Sci 7135: 7126: 7120: 7102: 7096: 7078: 7072: 7071: 7035: 7026: 7025: 7012: 7006: 7005: 7003: 7001: 6995: 6989:. Archived from 6988: 6980: 6974: 6973: 6966: 6960: 6959: 6948: 6942: 6941: 6930: 6924: 6923: 6916: 6910: 6909: 6898: 6892: 6891: 6889: 6887: 6872: 6866: 6863: 6857: 6856: 6845: 6839: 6832: 6826: 6817: 6811: 6805: 6799: 6783: 6777: 6776: 6748: 6742: 6726: 6715: 6710:Jones, R (1996) 6708: 6702: 6701: 6699: 6698: 6692: 6681: 6672: 6666: 6665: 6663: 6661: 6646: 6640: 6634: 6628: 6627: 6625: 6624: 6615:. Archived from 6594: 6588: 6587: 6586:(Press release). 6579: 6570: 6569: 6533: 6524: 6523: 6521: 6520: 6511:. Archived from 6488: 6482: 6481: 6479: 6477: 6472:on 30 April 2011 6461: 6455: 6454: 6418: 6412: 6411: 6393: 6387: 6386: 6350: 6344: 6343: 6307: 6301: 6300: 6290: 6256: 6250: 6249: 6247: 6245: 6228: 6222: 6221: 6209: 6203: 6202: 6166: 6157: 6156: 6149: 6143: 6137: 6131: 6130: 6094: 6088: 6074: 6068: 6067: 6057: 6025: 6019: 6005: 5999: 5993: 5984: 5983: 5947: 5941: 5931: 5925: 5911: 5905: 5904: 5893: 5887: 5886: 5884: 5883: 5874:. 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Archived from 5348: 5342: 5341: 5331: 5321: 5297: 5291: 5285: 5279: 5278: 5257: 5251: 5250: 5214: 5208: 5207: 5171: 5165: 5162:The ECT Handbook 5158: 5149: 5148: 5112: 5103: 5089: 5083: 5082: 5080: 5078: 5066: 5060: 5059: 5023: 5012: 5011: 4977: 4968: 4962: 4961: 4936:(8): 1401–1410. 4927: 4918: 4912: 4911: 4901: 4869: 4858: 4857: 4829: 4823: 4822: 4782: 4776: 4775: 4765: 4733: 4727: 4726: 4690: 4684: 4683: 4652: 4646: 4645: 4643: 4642: 4618: 4612: 4611: 4609: 4608: 4597: 4588: 4587: 4559: 4553: 4552: 4542: 4525:(7403): 1363–0. 4510: 4504: 4488: 4479: 4478: 4442: 4436: 4435: 4407: 4398: 4397: 4387: 4355: 4349: 4348: 4338: 4306: 4300: 4299: 4289: 4249: 4243: 4242: 4232: 4200: 4194: 4193: 4157: 4151: 4150: 4114: 4108: 4107: 4071: 4065: 4064: 4054: 4044: 4020: 4014: 3999: 3993: 3992: 3956: 3950: 3949: 3913: 3907: 3906: 3870: 3864: 3863: 3839: 3833: 3832: 3796: 3790: 3789: 3771: 3747: 3741: 3734: 3725: 3724: 3699:(9): 2127–2136. 3688: 3682: 3681: 3645: 3639: 3638: 3628: 3618: 3594: 3585: 3584: 3566: 3534: 3528: 3527: 3517: 3485: 3476: 3475: 3465: 3455: 3431: 3425: 3424: 3388: 3382: 3381: 3345: 3339: 3338: 3302: 3296: 3295: 3277: 3271: 3270: 3259: 3250: 3249: 3213: 3207: 3206: 3178: 3172: 3171: 3145: 3130: 3129: 3119: 3087: 3081: 3080: 3062: 3052: 3043:(6): 1345–1359. 3028: 3022: 3021: 2993: 2958: 2942: 2933: 2932: 2896: 2890: 2889: 2879: 2847: 2838: 2837: 2835: 2825: 2801: 2795: 2794: 2787: 2781: 2780: 2772: 2766: 2765: 2744: 2738: 2735: 2708: 2677: 2671: 2670: 2660: 2650: 2626: 2615: 2614: 2612: 2611: 2595: 2589: 2588: 2586: 2585: 2570: 2561: 2547: 2538: 2531: 2522: 2521: 2493: 2487: 2476: 2470: 2469: 2467: 2466: 2455: 2446: 2445: 2437: 2431: 2423:. Berlin, 1992, 2417: 2411: 2410: 2400: 2376: 2370: 2369: 2352:(9): 1034–1041. 2341: 2332: 2331: 2295: 2289: 2288: 2286: 2284: 2278: 2272:. Archived from 2239: 2230: 2224: 2223: 2211: 2205: 2204: 2194: 2170: 2164: 2163: 2161: 2160: 2154:plants.jstor.org 2146: 2140: 2134: 2128: 2127: 2125: 2086: 2077: 2071: 2058: 2052: 2051: 2015: 2004: 2003: 1983: 1964: 1957: 1936: 1927: 1910: 1909: 1907: 1906: 1900: 1893: 1884: 1878: 1877: 1875: 1864: 1855: 1786:Neurostimulation 1780: 1775: 1774: 1677:Wishful Drinking 1573:Ernest Hemingway 1552:trainees in the 1546:medical students 1426:advance decision 1342:Informed consent 934:heart arrhythmia 921:hyperventilation 706:For people with 515:informed consent 484:informed consent 176:mental disorders 138:edit on Wikidata 130: 104: 51: 39: 21: 7806: 7805: 7801: 7800: 7799: 7797: 7796: 7795: 7776:Neurotechnology 7751: 7750: 7731: 7726: 7716: 7714: 7705: 7704: 7700: 7691: 7689: 7680: 7679: 7675: 7637: 7636: 7632: 7594: 7593: 7589: 7582: 7567: 7566: 7562: 7549: 7539: 7527: 7506: 7505: 7501: 7494: 7486:. Grove Press. 7479: 7478: 7474: 7465: 7463: 7454: 7453: 7446: 7433: 7432: 7428: 7418: 7416: 7407: 7406: 7402: 7360: 7359: 7352: 7342: 7340: 7326: 7325: 7321: 7307: 7306: 7302: 7293: 7291: 7286: 7285: 7281: 7272: 7270: 7262: 7261: 7257: 7227: 7226: 7222: 7215: 7202: 7201: 7197: 7188: 7186: 7178: 7177: 7173: 7133: 7128: 7127: 7123: 7103: 7099: 7081:Meyers, Jeffrey 7079: 7075: 7037: 7036: 7029: 7014: 7013: 7009: 6999: 6997: 6993: 6986: 6982: 6981: 6977: 6972:. 25 June 2020. 6968: 6967: 6963: 6950: 6949: 6945: 6932: 6931: 6927: 6918: 6917: 6913: 6900: 6899: 6895: 6885: 6883: 6874: 6873: 6869: 6864: 6860: 6847: 6846: 6842: 6833: 6829: 6818: 6814: 6806: 6802: 6793:Wayback Machine 6784: 6780: 6759:(20): 141–150. 6750: 6749: 6745: 6727: 6718: 6709: 6705: 6696: 6694: 6690: 6679: 6674: 6673: 6669: 6659: 6657: 6648: 6647: 6643: 6635: 6631: 6622: 6620: 6596: 6595: 6591: 6581: 6580: 6573: 6535: 6534: 6527: 6518: 6516: 6503:(1237): U2051. 6490: 6489: 6485: 6475: 6473: 6463: 6462: 6458: 6420: 6419: 6415: 6408: 6395: 6394: 6390: 6352: 6351: 6347: 6309: 6308: 6304: 6258: 6257: 6253: 6243: 6241: 6230: 6229: 6225: 6211: 6210: 6206: 6168: 6167: 6160: 6151: 6150: 6146: 6138: 6134: 6096: 6095: 6091: 6087:. London: NICE. 6085:Wayback Machine 6075: 6071: 6027: 6026: 6022: 6016:Wayback Machine 6006: 6002: 5994: 5987: 5949: 5948: 5944: 5932: 5928: 5922:Wayback Machine 5912: 5908: 5895: 5894: 5890: 5881: 5879: 5865: 5864: 5860: 5833:Am J Psychiatry 5830: 5829: 5825: 5781: 5780: 5776: 5732: 5731: 5727: 5689: 5688: 5684: 5654: 5653: 5644: 5638:Wayback Machine 5628: 5624: 5590: 5589: 5585: 5576: 5574: 5565: 5564: 5560: 5552: 5548: 5494: 5493: 5489: 5479: 5477: 5471: 5470: 5466: 5422: 5421: 5417: 5379: 5378: 5374: 5365: 5363: 5350: 5349: 5345: 5300:Kala A (2013). 5299: 5298: 5294: 5286: 5282: 5259: 5258: 5254: 5216: 5215: 5211: 5173: 5172: 5168: 5159: 5152: 5117:Br J Psychiatry 5114: 5113: 5106: 5090: 5086: 5076: 5074: 5068: 5067: 5063: 5025: 5024: 5015: 4975: 4970: 4969: 4965: 4925: 4920: 4919: 4915: 4871: 4870: 4861: 4831: 4830: 4826: 4784: 4783: 4779: 4735: 4734: 4730: 4692: 4691: 4687: 4654: 4653: 4649: 4640: 4638: 4620: 4619: 4615: 4606: 4604: 4599: 4598: 4591: 4561: 4560: 4556: 4512: 4511: 4507: 4501:Wayback Machine 4489: 4482: 4444: 4443: 4439: 4409: 4408: 4401: 4357: 4356: 4352: 4308: 4307: 4303: 4251: 4250: 4246: 4202: 4201: 4197: 4159: 4158: 4154: 4116: 4115: 4111: 4073: 4072: 4068: 4022: 4021: 4017: 4000: 3996: 3958: 3957: 3953: 3915: 3914: 3910: 3872: 3871: 3867: 3846:(2): CD000076. 3841: 3840: 3836: 3798: 3797: 3793: 3749: 3748: 3744: 3735: 3728: 3690: 3689: 3685: 3647: 3646: 3642: 3596: 3595: 3588: 3536: 3535: 3531: 3487: 3486: 3479: 3433: 3432: 3428: 3390: 3389: 3385: 3347: 3346: 3342: 3304: 3303: 3299: 3292: 3279: 3278: 3274: 3261: 3260: 3253: 3224:(S6): S48–S51. 3215: 3214: 3210: 3180: 3179: 3175: 3168: 3147: 3146: 3133: 3089: 3088: 3084: 3030: 3029: 3025: 2995: 2994: 2961: 2955:Wayback Machine 2943: 2936: 2898: 2897: 2893: 2849: 2848: 2841: 2803: 2802: 2798: 2789: 2788: 2784: 2774: 2773: 2769: 2746: 2745: 2741: 2724: 2711: 2682: 2678: 2674: 2648:10.1002/brb3.37 2628: 2627: 2618: 2609: 2607: 2597: 2596: 2592: 2583: 2581: 2572: 2571: 2564: 2548: 2541: 2532: 2525: 2495: 2494: 2490: 2477: 2473: 2464: 2462: 2457: 2456: 2449: 2439: 2438: 2434: 2418: 2414: 2378: 2377: 2373: 2343: 2342: 2335: 2297: 2296: 2292: 2282: 2280: 2276: 2237: 2232: 2231: 2227: 2213: 2212: 2208: 2172: 2171: 2167: 2158: 2156: 2148: 2147: 2143: 2135: 2131: 2123: 2084: 2079: 2078: 2074: 2069:Wayback Machine 2059: 2055: 2017: 2016: 2007: 2000: 1985: 1984: 1967: 1958: 1939: 1928: 1913: 1904: 1902: 1898: 1891: 1886: 1885: 1881: 1873: 1862: 1857: 1856: 1813: 1809: 1776: 1769: 1766: 1743:Miracle Musical 1732:graveyard shift 1698: 1670:American actor 1633:Sargent Shriver 1629:George McGovern 1609:Thomas Eagleton 1569: 1563: 1537: 1513: 1489: 1470: 1465: 1454:. In 2014, the 1445:. In 1976, the 1439: 1409: 1400: 1388: 1386:Involuntary ECT 1344: 1339: 1330: 1325: 1297: 1249: 1224: 1204: 1159: 1122: 1113: 1104: 1089:benzodiazepines 1081: 1072: 963:Glenside Museum 955: 930: 909:anticholinergic 900: 884: 868:semantic memory 836: 827: 791:, which induce 785:benzodiazepines 780:muscle soreness 764: 736: 716: 699: 677:antidepressants 668: 603: 567: 511: 503:neuroplasticity 428:Surgeon General 290:Giovanni Aldini 264: 242: 227:muscle relaxant 141: 126: 100: 58: 37: 28: 23: 22: 15: 12: 11: 5: 7804: 7802: 7794: 7793: 7788: 7783: 7778: 7773: 7768: 7763: 7753: 7752: 7749: 7748: 7742: 7730: 7729:External links 7727: 7725: 7724: 7698: 7673: 7646:(3): 187–191. 7630: 7603:(6): 882–891. 7587: 7580: 7560: 7551:|journal= 7525: 7499: 7492: 7472: 7444: 7426: 7400: 7373:(5): 469–471. 7350: 7339:on May 3, 2009 7319: 7300: 7279: 7255: 7236:(5): 485–486. 7220: 7213: 7195: 7171: 7121: 7105:A. E. Hotchner 7097: 7073: 7046:(4): 244–253. 7027: 7007: 6975: 6961: 6943: 6925: 6911: 6893: 6867: 6858: 6840: 6827: 6812: 6800: 6778: 6743: 6716: 6703: 6667: 6641: 6629: 6589: 6571: 6544:(3): 247–273. 6525: 6483: 6456: 6429:(3): 289–294. 6413: 6406: 6388: 6345: 6318:(6): 589–599. 6302: 6251: 6223: 6204: 6177:(4): 206–212. 6158: 6144: 6132: 6105:(5): 401–405. 6089: 6069: 6020: 6000: 5985: 5942: 5926: 5906: 5888: 5858: 5839:(6): 869–875. 5823: 5794:(7): 492–497. 5774: 5745:(4): 263–267. 5725: 5698:(4): 235–236. 5682: 5642: 5622: 5583: 5558: 5546: 5507:(3): 207–218. 5487: 5464: 5435:(3): 196–201. 5415: 5372: 5343: 5312:(3): 216–219. 5292: 5280: 5269:(11): 644–50. 5263:East Afr Med J 5252: 5225:(2): 100–104. 5209: 5166: 5150: 5123:(5): 401–405. 5104: 5101:978-1904671220 5084: 5061: 5034:(5): 929–934. 5013: 4963: 4913: 4878:Anesthesiology 4859: 4840:(5): 444–450. 4824: 4797:(5): 261–271. 4777: 4748:(4): 327–335. 4728: 4701:(3): 180–195. 4685: 4666:(7): 929–932. 4647: 4613: 4589: 4570:(4): 348–356. 4554: 4505: 4480: 4453:(2): 127–133. 4437: 4418:(6): 581–590. 4399: 4370:(3): 226–234. 4350: 4301: 4264:(2): 165–176. 4244: 4195: 4168:(2): 105–108. 4152: 4125:(5): 388–397. 4109: 4082:(6): 354–358. 4066: 4015: 4013:, pp. 161–280. 4011:978-0199937899 3994: 3951: 3924:(4): e59–e60. 3908: 3881:(6): 616–617. 3865: 3834: 3807:(6): 676–686. 3791: 3762:(5): 285–300. 3742: 3726: 3683: 3656:(7): 675–687. 3640: 3586: 3549:(4): 294–306. 3529: 3477: 3426: 3383: 3340: 3297: 3290: 3272: 3251: 3208: 3173: 3166: 3131: 3082: 3023: 3004:(7): 667–672. 2959: 2934: 2907:(2): 182–185. 2891: 2862:(6): 540–549. 2839: 2796: 2782: 2767: 2756:(2): 445–454. 2739: 2737: 2736: 2722: 2709: 2672: 2641:(3): 283–344. 2616: 2590: 2562: 2539: 2523: 2488: 2471: 2447: 2432: 2419:Bangen, Hans: 2412: 2371: 2333: 2290: 2248:(2): 157–162. 2225: 2206: 2185:(4): 576–584. 2165: 2141: 2129: 2095:(3): 518–530. 2072: 2053: 2005: 1998: 1965: 1937: 1911: 1879: 1810: 1808: 1805: 1804: 1803: 1798: 1793: 1788: 1782: 1781: 1765: 1762: 1756:and attempted 1697: 1694: 1693: 1692: 1681: 1668: 1655: 1648: 1640: 1605: 1604: 1590: 1589: 1565:Main article: 1562: 1559: 1554:United Kingdom 1536: 1533: 1512: 1509: 1488: 1485: 1469: 1466: 1464: 1461: 1438: 1435: 1408: 1407:United Kingdom 1405: 1399: 1396: 1387: 1384: 1343: 1340: 1338: 1335: 1329: 1326: 1324: 1321: 1296: 1293: 1248: 1247:United Kingdom 1245: 1223: 1220: 1203: 1200: 1182:tracts in the 1158: 1155: 1121: 1118: 1112: 1111:Treatment team 1109: 1103: 1100: 1080: 1077: 1071: 1068: 1043:The patient's 1010:dose titration 954: 951: 929: 926: 899: 896: 892:Journal of ECT 883: 880: 835: 832: 826: 823: 763: 760: 748:antipsychotics 735: 732: 715: 712: 698: 695: 667: 664: 650:Compared with 602: 599: 566: 563: 555:hallucinations 510: 507: 505:and rewiring. 488:mental illness 424:antidepressant 250:Bergonic chair 241: 238: 143: 142: 135: 132: 131: 124: 118: 117: 112: 106: 105: 98: 92: 91: 86: 80: 79: 74: 68: 67: 64: 60: 59: 52: 44: 43: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 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7053: 7049: 7045: 7041: 7034: 7032: 7028: 7023: 7022: 7017: 7011: 7008: 6996:on 2013-01-08 6992: 6985: 6979: 6976: 6971: 6965: 6962: 6957: 6953: 6947: 6944: 6939: 6935: 6929: 6926: 6921: 6915: 6912: 6907: 6903: 6897: 6894: 6882: 6878: 6871: 6868: 6862: 6859: 6854: 6850: 6844: 6841: 6837: 6831: 6828: 6825: 6821: 6816: 6813: 6810: 6804: 6801: 6798: 6794: 6790: 6787: 6782: 6779: 6774: 6770: 6766: 6762: 6758: 6754: 6747: 6744: 6740: 6737: 6736: 6731: 6725: 6723: 6721: 6717: 6713: 6707: 6704: 6689: 6685: 6678: 6671: 6668: 6656: 6652: 6649:Mechcatie E. 6645: 6642: 6639: 6633: 6630: 6619:on 2012-08-21 6618: 6614: 6610: 6609: 6604: 6602: 6593: 6590: 6585: 6578: 6576: 6572: 6567: 6563: 6559: 6555: 6551: 6547: 6543: 6539: 6532: 6530: 6526: 6515:on 2011-05-01 6514: 6510: 6506: 6502: 6498: 6494: 6487: 6484: 6471: 6467: 6460: 6457: 6452: 6448: 6444: 6440: 6436: 6432: 6428: 6424: 6417: 6414: 6409: 6403: 6399: 6392: 6389: 6384: 6380: 6376: 6372: 6368: 6364: 6360: 6356: 6349: 6346: 6341: 6337: 6333: 6329: 6325: 6321: 6317: 6313: 6306: 6303: 6298: 6294: 6289: 6284: 6280: 6276: 6272: 6268: 6267: 6262: 6255: 6252: 6240: 6239: 6234: 6227: 6224: 6219: 6215: 6208: 6205: 6200: 6196: 6192: 6188: 6184: 6180: 6176: 6172: 6165: 6163: 6159: 6154: 6148: 6145: 6141: 6136: 6133: 6128: 6124: 6120: 6116: 6112: 6108: 6104: 6100: 6093: 6090: 6086: 6082: 6079: 6076:NICE (2003). 6073: 6070: 6065: 6061: 6056: 6051: 6047: 6043: 6039: 6035: 6031: 6024: 6021: 6017: 6013: 6010: 6004: 6001: 5997: 5992: 5990: 5986: 5981: 5977: 5973: 5969: 5965: 5961: 5957: 5953: 5946: 5943: 5939: 5936: 5930: 5927: 5923: 5919: 5916: 5910: 5907: 5902: 5898: 5892: 5889: 5878:on 2008-01-15 5877: 5873: 5869: 5862: 5859: 5854: 5850: 5846: 5842: 5838: 5834: 5827: 5824: 5819: 5815: 5810: 5805: 5801: 5797: 5793: 5789: 5785: 5778: 5775: 5770: 5766: 5761: 5756: 5752: 5748: 5744: 5740: 5736: 5729: 5726: 5721: 5717: 5713: 5709: 5705: 5701: 5697: 5693: 5686: 5683: 5678: 5674: 5670: 5666: 5662: 5658: 5651: 5649: 5647: 5643: 5639: 5635: 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