Electroconvulsive Therapy in Pediatrics
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Abstract Objectives: In child and adolescent psychiatry, catatonia is infrequent, but it is one of the most severe syndromes, characterized by the coexistence of psychic and motor symptoms. It is also unclear whether or not ECT is effective. In some cases, the numbers are extremely favorable, citing 80 percent improvement in severely depressed patients, after ECT.
However, other studies indicate that the relapse is high, even for patients who take medication after ECT. Some researchers insist that no study proves that ECT is effective for more than four weeks.
This coincides with changing demographics. Unfortunately, concerns have been raised concerning inappropriate and even dangerous treatment of elderly patients with heart conditions, and the administration of ECT without proper patient consent. The patient and physician should discuss all options available before deciding on any treatment.
If ECT is recommended, the patient should be given a complete medical examination including a history, physical, neurological examination, EKG and laboratory test. Medications need to be noted and monitored closely, as should cardiac conditions and hypertension.
The patient and family should be educated and informed about the procedure via videos, written material, discussion, and any other means available before a written consent is signed. The procedure should be administered by trained health professionals with experience in ECT administration as well as a specifically trained and certified anesthesiologist to administer the anesthesia.
The seizure initiated by the electrical stimulus varies from person to person and should be monitored carefully by the administration team. The nature of ECT, its history of abuse, unfavorable medical and media reports, and testimony from former patients all contribute to the debate surrounding its use.
Research should continue, and techniques should be refined to maximize the efficacy and minimize the risks and side effects resulting from ECT. What is ECT? How is it administered? Why is ECT so controversial? Is ECT an option?