Indications for electroconvulsive therapy

Electroconvulsive therapy is mainly used in the field of psychiatric treatment. It is very good for us to treat depression and patients with strong suicidal tendencies. This is mainly because electroconvulsive therapy is short-term and can be used to restore patients with respiratory arrest. For specific indications, we should choose the treatment method based on the doctor's advice, so it is recommended that everyone understand the value of electroconvulsive therapy.

Electroconvulsive therapy is an older method that was widely used in various psychiatric treatment areas in the 1930s to 1950s. Since the development and widespread clinical application of psychotropic drugs in the 1950s, the objects, scope and usage rate of their treatment have been significantly reduced and gradually replaced by drugs. The biggest drawback of electroconvulsive therapy is that it takes effect quickly, but the therapeutic effect lasts for a short time, the recurrence rate is high, and it has negative effects on patients such as psychological pressure.

However, electroconvulsive therapy still has clear therapeutic indications for a very small number of patients with depression, and sometimes it cannot be replaced by antidepressants. The following are good indications: ① severe depression, especially those with severe biological somatic signs and psychotic symptoms; ② patients with strong suicidal behavior, who are very dangerous and need to be prevented from accidents, or those who have been discovered and stopped for multiple suicidal behaviors; ③ patients with anorexia and depressive stupor that threaten their lives, etc.

It must be pointed out that the modified non-convulsive electroconvulsive therapy currently used in clinical practice is relatively safe, has fewer complications, and is more easily accepted by patients. Many patients can expect to achieve excellent results in 3 to 6 sessions under outpatient treatment conditions and then switch to antidepressant treatment.

complication

The incidence of complications from electroconvulsive therapy is not high, but once it occurs, the consequences are serious and should be taken seriously.

1. Fractures and dislocations are most commonly spinal compression fractures, followed by limb fractures. If a fracture occurs, electrotherapy should be stopped and orthopedic treatment should be performed. If the mandible is dislocated, it should be manually repositioned immediately, and repositioning will not affect the treatment.

2. Respiratory arrest usually occurs about 10 seconds after the convulsion stops, and breathing will resume automatically. If breathing has not recovered after 30 seconds, artificial respiration must be performed immediately, the airway must be kept open, and rescue must be carried out in time. To prevent poor respiratory recovery or respiratory arrest, one injection of lobeline can be given before treatment.

3. After treatment of circulatory collapse, if the patient is found to have pale skin, low blood pressure, and a weak and rapid pulse, central nervous system stimulants and cardiotonic drugs, such as epinephrine, nikethamide, caffeine, etc., should be injected quickly. The factors that lead to collapse should be carefully identified and treated promptly, and electroconvulsive therapy should be discontinued if necessary.