Posted by Cam W. on May 12, 2000, at 22:37:02
In reply to Re: ECT literature search, posted by SLS on May 12, 2000, at 9:02:26
> How prevalent is the practice of choosing ECT as the first treatment [in pregnancy]? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.
I was paraphrasing from a study I had read. If a pregnant woman were taking an MAOI, after failing other ADs, I believe that many docs would opt for ECT rather than risking damage to the fetus. Granted, SSRIs have supplanted ECT in North America. I am not sure what Europe is doing. A quick search on Pub Med gives mixed reviews. Case reports of complications interspersed with articles stating the safety of ECT in pregnancy. The article I have at work wasn't listed.
> Does ECT exert a greater effect on HPA function than do antidepressants?
> Is success rate of ECT as high for bipolar depression as it is for melancholic and psychotic depressions?
I don't know for sure, but I do know that it is used quite extensively in refractory cases of bipolar disorder, psychotic depressions, and atypical depressions.
> If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints? I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.
I have since talked to a couple of psychiatrists at work and yes, ECT without patient consent (but usually with family consent) is sometimes necessary, when traditional treatments aren't working.
Making a long thread even longer - Cam