Electroconvulsive Therapy: Maximising Benefits, Minimising Adverse Effects

Salam Hussain, Alan Weiss, Sue Waite

Research output: Contribution to conferenceAbstract

Abstract

Background:
Electroconvulsive Therapy remains the most effective method of treating major depression and other severe psychiatric disorders. One of the main concerns about ECT is the potential for cognitive adverse effects. To promote ECT techniques aimed at recovery that promote the lowest cognitive impairment whilst retaining efficacy, the RANZCP Section of Electroconvulsive Therapy and Neurostimulation has developed a professional practice guideline (PPG) that aims to summarise current evidence and guide practitioners using ECT to deliver optimal outcomes.

Objectives:
This update aims to improve the understanding of clinical indications for ECT, the potential complications and contraindications to treatment. It will provide an opportuntity for psychaitrists to become familiar with recent advances in ECT treatment approaches, including the effects of varying electrode placement, stimulus parameters, and frequency to ensure that the technical procedure is applied optimally for any given patient.

Methods:
Relevant literature and case examples will be presented to illustrate the patient factors that may impact on the choice of ECT and the patient’s potential vulnerability to cognitive and physical adverse effects. The parameters of ECT practice that will be discussed include: electrode placement, pulse width, anaesthetic management, monitoring of outcomes, and the role of continuation and maintenance ECT. There will also be a discussion about strategies to improve outcomes in high risk groups (such as pregnant patients, the elderly and people with medical comorbidity), through optimal application of anaesthetic procedures and concurrent mediations. Furthermore, an overview will be presented of the potential use of biomarkers to predict response to ECT. Participants will be encouraged to contribute and use case material to inform discussion.

Findings:
ECT is a constantly evolving practice, and ongoing research in the area continues to provide potential for treatment refinement and improvement, including novel approaches to ECT.

Conclusions:
Psychiatrists are encouraged to improve their knowledge of ECT, to follow evidence based practice and to collaborate with colleagues to make the determination as to when ECT is indicated and what modality of ECT to use.
Original languageEnglish
Publication statusPublished - 15 May 2018
EventThe Royal Australian & New Zealand College of Psychiatrists 2018 Congress: Becoming well together: Partnerships in mental health, Ngā hononga ō te hauora hinengaro - Auckland, New Zealand
Duration: 13 May 201817 May 2018
https://www.ranzcp2018.com/

Conference

ConferenceThe Royal Australian & New Zealand College of Psychiatrists 2018 Congress
CountryNew Zealand
CityAuckland
Period13/05/1817/05/18
Internet address

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    Hussain, S., Weiss, A., & Waite, S. (2018). Electroconvulsive Therapy: Maximising Benefits, Minimising Adverse Effects. Abstract from The Royal Australian & New Zealand College of Psychiatrists 2018 Congress, Auckland, New Zealand.