Posted by stargazer2 on September 18, 2007, at 8:55:46
In reply to Re: Forced to terminate current Pdoc after Nardil fail, posted by olysi79 on September 17, 2007, at 23:47:13
ECT is usually given intially 3 times a week until benefits are shown, then it is decreased to 2 times a week, then 1X a week, until a course of 8-12 treatments are given. Some people show no improvement and continued treatment is given until the MD or the pt (more often) say that is enough. After that, maintenance ECT is usually recommended 1x a month. The schedule is highly variable by individual and by MD.
I worked in a ECT dept and I saw many patients who did not have really good trials of medications undergo ECT. The ECT doctor was not an expert in medications and some pts did not get the benefit of expert medication management before ECT was recommended. The ECT doc was not experienced himself and I thought was a bit too eager to give ECT without offering any other alternative. Why would he even if a patient pushed for a longer med trial since ECT presented as the only option.
I was not overly impressed with the outcomes of ECT. I saw some people improve but many did not. Several went onto to commit suicide anyway.
As you can tell from reading many of the posts with MD's not experienced with medication combinations, ECT is probably suggested more often than necessary and if someone is suicidal and medication is not working, the belief is that ECT is the last chance they have. All I know is that when I was suicidal, Seroquel got me out of it and I would use it again rather than undergo ECT.
Since I know alot about the procedure, I am very skeptical of it's efficacy. I think it can disrupt the brain enough to change someones' behavior very quickly, but I'm not so sure about it's long term success as a treatment for depression. At least with medications, side effects are mostly reversible but with ECT they are not. Again this is my opinion and not a suggestion that others feel this way. In some cases, ECT is all that is offered as a next step but I believe a next step should be to a psychopharmacologist and that step is almost always skipped.