ELECTROCONVULSIVE-THERAPY - RISKS AND INDICATIONS

Modified electroconvulsive therapy (ECT), which is carried out in general anesthesia, with muscular relaxation and oxygen application, can today be considered a safe treatment. Orthopaedic complications (fractures, dislocations) do not occur anymore, the rise of the heart rate and blood pressure during the seizure is diminished and the degree of memory impairment reduced. The latter side effect could furthermore be lessened by applying pulse stimuli. Amnesia, if it occurs, is mainly reversible; in few instances a permanent impairment can be observed, but this only concerns the days or weeks before treatment. Thus, because of the low rate of adverse effects the benefit outweighs the risks in clinical conditions which cannot be improved by psychopharmacotherapy - or to a lesser degree than with ECT: endogenous depression with retardation and/or delusions, schizoaffective psychosis, depressed type, and catatonia.