Electroconvulsive Therapy (ECT): Important parameters which influence its effectiveness

摘要

Electroconvulsive therapy (ECT) is usually given to people with severe depression which has not responded to other forms of treatment such as anti-depressants. However, it is sometimes used for people with a diagnosis of bi-polar disorder or schizophrenia. It was originally developed in the 1930s and was used widely during the 1950s and 1960s for a variety of conditions. ECT consists of passing an electrical current through the brain to produce an epileptic fit – hence the name, electro-convulsive. The idea developed from the observation that, in the days before there was any kind of effective medication, some people with depression or schizophrenia, and who also had epilepsy, seemed to feel better after having a fit. The mechanism of action of ECT is not fully known. ECT affects multiple central nervous system components, including hormones, neuropeptides, neurotropic factors, and neurotransmitters. The induction of a bilateral generalized seizure is required for both the beneficial and adverse effects of ECT. Certain parameters like seizure duration, electric stimuli, seizure threshold, ECT practice factors and medication can influence its efficacy or effectiveness. This study aims to review the evidence base of these parameters in detail