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Post-Ept Case Studies

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Electroconvulsive Therapy (ECT) is a long-standing treatment option for depression in patients who have not responded to medications. Emergence agitation occurs in approximately 1 in 10 patients post-ECT.1 The agitation is often mild, and can be settled through non-pharmacological means such as verbal reassurance, however, in some patients agitation can be severe and require pharmacological interventions. We describe a case of severe post-ECT agitation which failed treatment with propofol, esmolol and midazolam, but responded well to dexmedetomidine. Miss T, a 19 year old female with a 3 year history of major depression with melancholic features, was referred for ECT following suicidal ideation. The patient underwent 10 treatments with right unilateral electrode placement and a stimulus dose of 35%. Anaesthesia consisted of propofol, 80-90mg; succinylcholine 50-60mg was used as a paralytic. Upon awakening during the first 8 treatments, Miss T was extremely agitated, restless and confused. This lasted up to 60 minutes and required 7 staff to maintain the safety of herself and others. Richmond Agitation Sedation Scale (RASS) score was +3 or +4 every treatment. Increasing doses of propofol, up to 420mg, were administered …show more content…

Treatment-Resistant Postictal Agitation After Electroconvulsive Therapy (ECT) Controlled With Dexmedetomidine. The Journal of ECT. 2013;29(2):e18. O 'Brien, E., Rosenquist, P., Kimball, J., Dunn, G., Smith, B. and Arias, L. (2010). Dexmedetomidine and the Successful Management of Electroconvulsive Therapy Postictal Agitation. The Journal of ECT, 26(2), pp.131-133. Cohen, M. and Stewart, J. (2013). Treatment of Post-Electroconvulsive Therapy Agitation With Dexmedetomidine. The Journal of ECT, 29(2), pp.e23-e24. Mizrak, A., Koruk, S., Ganidagli, S., Bulut, M. and Oner, U. (2009). Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy. J Anesth, 23(1),

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Ofc Jaques was able to see to it that the subjects face and head did not hit the floor. I then grabbed both of the subjects feet in order for him not to kick or push with them. I removed both socks and shoes and the subject advised, "OK, I 'm good". Ofc Jaques and I then assisted him to his knees and he then sat outside of the cell for a few seconds. He claimed he needed a few seconds because he did not take his seizure medicine.

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The patient is a 42-year-old female who comes to the emergency room with a diagnosis of recurrent seizures. The patient is noted to have a long-standing history of pseudo seizures. She is followed by a psychiatrist and neurologist as outpatient. She presented the day of presentation having had 2 seizures at home and seizure in the emergency room. During the seizures she did not lose any consciousness or had no incontinence.

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I really enjoyed this talk by Sherwin Nuland about how he became so severely depressed due to a bad marriage that even the doctors thought nothing could be done for him. They felt the only thing left that might fix him, was a pre-fontal lobotomy and thankfully for him and for us that did not happen. If he had had a lobotomy, I doubt we would have had the chance to hear that wonderful speech he just gave. Anyhow, I was aware that electroshock convulsive shock therapy is one of the last resort treatments for depression and that it can help those that are severely depressed when nothing else would work. In fact, my husband’s grandmother received a form of it called insulin shock therapy for her depression many decades ago.

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I did not watch the video, so all of my information is coming from the book. I am going to start off by saying I do think the electroconvulsive therapy is ethical. In the book, it clearly states that this treatment is very effective when used for unipolar depression. If that is true, why not use it on people that are willing? I think it is the person 's job who is doing the treatment to fully explain all of the factors and risks that may happen before doing this treatment.

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CVA due to dedication and motivation but still had disorientation issues. After talking with the patient and finding out that the patient’s occupation of rest was compromised, I explained to the patient how rest is important for the body to heal itself and suggested the veteran “take it easy” and focus on rest. The veteran came back to the appointment reporting no disorientation after taking the

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Though there is debate over the effects of electroconvulsive therapy and whether or not it is helpful to those who suffer from severe depression that has remained untreatable with other methods of intervention, I do not consider electroconvulsive therapy unethical; however, I do believe, and I am of the opinion that most medical professionals also agree, that ECT should be implemented only when all other methods of intervention have proved to be unsuccessful. There are patients and professionals who espouse that ECT is in fact helpful, and there are those on the opposite end of the spectrum who believe that it is ineffective and causes irreversible damage to the patient. With any subject, there are people who possess separate views; however, with the limited knowledge I have about ECT, I do not think it is unethical. It would be unethical if a person was forced to undergo the treatment, but having ECT is a choice made together by the patient and doctor who

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At pretreatment, ECT-treated patients were more depressed than the non treated group. Significantly more ECT-treated patients were favorable about ECT, compared to patients never treated with ECT, both at pretreatment and at post-treatment. Favorable attitudes were maintained after 6 months. ECT-treated patients, initially uncertain or negative about ECT, changed to a favorable attitude after completing treatment. 98% of ECT-treated patients said they would agree to ECT if they became depressed

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She also says that proposes many psychiatrists consider that ECT is the most successful way to treat patients who do not respond to antidepressants and imperative for preventing suicide attempts. With this therapy there is a risk of having brain damage and the side effects of it. Although I agree with Dahl to a point, I cannot accept her overall conclusion that this therapy is helpful because of the side effects because it can cause brain damage and other problems after the therapy.

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