Mental health articles

OF mental health care and mentally ill

Electroconvulsive therapy in treating depression

The greater the number of typical features of depression, the greater likelihood of a good response to electroconvulsive therapy

Electroconvulsive therapy is particularly effective in treating depression with psychotic features

Patients who do not respond to antidepressant drugs may respond to electroconvulsive therapy

It is essential to continue drug treatment with antidepressants after a successful course of electroconvulsive therapy

Safety of electroconvulsive therapy

There are no absolute contraindications to its use. Relative contraindications include uncontrolled hypertension, recent myocardial infarction or haemorrhagic stroke

It may be a life-saving treatment in cases of severe depression

There is limited evidence that it causes brain damage or permanent intellectual impairment; this must be weighed against its established efficacy in life-threatening severe depression

Risk of death is similar to that of general anaesthesia for minor surgical procedures – about two deaths per 100,000 treatments

Several drugs, including selective serotonin reuptake inhibitors, may prolong the duration of the induced seizur

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