Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Vagal Nerve Stimulation, Deep Brain Stimulation, Ablative Neurosurgery, Mood Disorders, Treatment-Resistant Depression, Catatonia, Neuroplasticity, Neurotransmitter Modulation, Brain Circuitry,

Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Vagal Nerve Stimulation, Deep Brain Stimulation, Ablative Neurosurgery, Mood Disorders, Treatment-Resistant Depression, Catatonia, Neuroplasticity, Neurotransmitter Modulation, Brain Circuitry, Psychiatric and Neurological Interventions, Safety, Contraindications, Anesthesia, Seizure Management, Cognitive Effects, Clinical Efficacy, Targeted Brain Stimulation, Advanced Psychophysiological Therapies Questions Verified and Complete with A+ Graded RATIONALES LATEST UPDATED 2026 Electroconvulsive Therapy (ECT) the use of small electric current to produce a brief generalized cerebral seizure under general anesthesia in order to quickly reverse certain mental health symptoms Electroconvulsive Therapy (ECT) Extremely effective!!! Effect size 2 (the most effective tx we actually have) Electroconvulsive Therapy (ECT) • Increase of release monoamine neurotransmitters (dopamine, serotonin, and norepinephrine) • Relieves depression by causing hypothalamus or pituitary gland to release hormones • Decrease seizure threshold and cause anticonvulsant properties • Increase neurotrophic signaling and inducing brain structural plasticity Electroconvulsive Therapy (ECT) Indications: • Mood Disorders • Refractory to antidepressant medications • Situations where rapid response is required (pregnancy, persistent suicidal attempt, refusal of oral intake) • Psychotic features • CATATONIA • Previous response to ECT • Parkinson disease • Neuroleptic malignant syndrome Electroconvulsive Therapy (ECT) -if used alone, relapse rate is very high • 80-90% response rate when used as a first line treatment in unipolar or bipolar depression • 50-60% response rate in treatment-resistant depression, where there is failure to respond to antidepressant medication. Electroconvulsive Therapy (ECT) • Administered 2-3 times per week for total of 6-12 treatments • 30-90 sec generalized tonic clonic seizure • Premedication is often used • Anesthesia • Maintenance course - one treatment every 1-8 weeks Methohexital or Etomidate Anesthesia of choice for ECT Atropine or Glycopyrrolate common premedication for ECT to reduce secretions and bradyarrthymias Succinylcholine -used for skeletal muscle relaxation and to attenuate seizure activity during ECT Pulse Most of the time ECT devices deliver a stimuli per a brief bidirectional __________ wave which is associated with less cognitive impairment Continuous In ECT, occasionally a _______________ sinusoidal wave is used for treatment resistant cases Bilateral Placement of electrodes for ECT: greatest efficacy and quickest response, but most memory impairment Right Unilateral Placement of electrodes for ECT: slightly lower remission rates, but fewer adverse cognitive effects Bifrontal Placement of electrodes for ECT: smaller evidence of efficacy (not often used) Stimulus Dosing A process called "____________________" has been developed for ECT to deliver the amount of electricity needed to be therapeutic yet keep this to the minimum needed stimuli. Millicoulombs (mC) Unit of electrical charge for ECT is measured in _______________________ 2.5 For Bilateral ECT to have therapeutic response the electrical dosage must be roughly ____________ times the "threshold". 6 For Right Unilateral place to have therapeutic response the electrical dose must be roughly about _____ times the "threshold". -space occupying lesion causing intracranial pressure -intracerebral hemorrhage -unstable aneurysms or vascular malformation What are some Absolute CIs for ECT? -Headaches -Nausea -Muscle pain Most common side effects assoc with ECT Acute Confusion effect that can occur for 10-30 minutes after ECT