A TASK FORCE REPORT OF THE AMERICAN PSYCHIATRIC ASSOCIATION 2001

THE PRACTICE OF ELECTROCONVULSIVE THERAPY
RECOMMENDATIONS FOR TREATMENT, TRAINING, AND PRIVILEGING
SECOND EDITION

A TASK FORCE REPORT OF THE AMERICAN PSYCHIATRIC ASSOCIATION 2001

SUMMARY

* ECT should not be reserved for use only as a “last resort”

* Some medical conditions substantially increase the risk of ECT treatment

* Elderly patients maybe at greater risk for more persistent confusion and greater memory deficits during and after ECT

* Few studies address the use of ECT in children and adolescents

* To some extent, medical adverse events can be anticipated

* ECT facilities should be appropriately equipped and staffed with personnel to manage potential clinical emergencies

* Each facility should have a minimal set of procedures that are to be undertaken in all cases

* It is incumbent on facilities using ECT to implement and monitor compliance with reasonable and appropriate policies and procedures

* The patient should provide informed consent unless he or she lacks capacity

* There is no clear consensus about what constitutes the capacity to consent

* There may be concern that the attending physician is biased toward finding that capacity to consent exists when the patient’s decision agrees with his or her own

* Continued use of certain ECT devices is not justified, including sine wave, constant voltage and constant energy devices

* Patients should be monitored during ECT

* Continued therapy has become the rule in contemporary practice … the risk of relapse after ECT is very high…the need for aggressive continuation therapy … is compelling and it should be instituted as soon as possible

* After ECT, concern over recurrence of illness is so great- -that maintenance therapy should be initiated in virtually all patients receiving continuation therapy

* The absence of controlled studies of the efficacy or safety of long-term maintenance ECT

* The patient’s medical record is a legal document … the clinical record should contain a summary of major consent related discussions

* The practice of ECT is a highly technical and sophisticated medical procedure

* ECT training in residency programs in the U.S. ranges from excellent to totally absent. In many cases, the training is no more than minimal

* No national accrediting body presently provides assurance of clinical competency in ECT

* It is clear that general privileging in psychiatry will riot suffice and that specific privileges to administer ECT should be required

Comments (5)

jenny schmitzAugust 23rd, 2009 at 7:15 pm

I may feel worse than I did before.

jenny schmitzAugust 23rd, 2009 at 7:35 pm

I said that to make sure it got through. But, my questions are un-ending. Is ther a conflict of interset if a doctor both performs and owns a large portion of the ECT equipment? If there are only, ” few studies address the use of ECT in children and adolescent,” do we have the right and accurate knowledge to perform electroshock on them? What staff is required to have,”knowledge to attend personal electroconvulsive opperations?” What is involved in a patient’s consent? How do we judge when a patient either is or is not compitant to sign his or her consent form? Do we have a historical link to the number of patients recieving ects under particular doctors? Has the amount of volts gone up or down in the last 35 years? Who are the largest advocates for ects and the largest oppinents of ects? How many “sessions” are allowed per person and in what time period? What is the average amount of ects a person recieves? What would be considered over the amount of ects a person should recieve? Finally, is there a means to find information and history on the doctor who plans to shock you? Is there a website to praise or complain about an ect doctor?

Simonne JaresSeptember 9th, 2011 at 10:37 pm

Good day! I know this is somewhat off topic but I was wondering which blog platform are you using for this site? I’m getting fed up of WordPress because I’ve had problems with hackers and I’m looking at alternatives for another platform. I would be great if you could point me in the direction of a good platform.

CuteFTPSeptember 30th, 2011 at 4:01 am

I conceive this internet website contains some rattling wonderful information for everyone : D.

EliasJuly 14th, 2012 at 4:29 am

This is just me putting this out there, but if your dsierespon is due to a chemical imbalance you may need medication to balance them out. Other than that, I suggest just seeing a therapist (not a psychiatrist, they’re not going to force any medications on you because they are not medical doctors). Therapy could help get to the root of what is causing your dsierespon. When first going to therapy it may make you feel a little worse, because no one likes talking about what upsets them. Over time however, it will help you tremendously, if you let it. Also, whenever you feel anxious or the need to hurt yourself in any way, try deep breathing exercises. This may calm you down until you have a clear head. You could also try hypnotherapy, I’ve spoken with many people who used to suffer from things like anxiety and hypnotherapy helped them greatly. Whatever you do, PLEASE do not harm yourself. I have also attempted suicide, 3 times and I came very close to it the last time. I understand what it’s like to want to end it all, but I’ve gotten better and you can too. If you ever need anyone to talk to, maybe even to just vent a little bit, please feel free to email me. I’m sure I can relate and maybe help you out a little.I hope this helps you!

Leave a comment

Your comment:

Subscribe without commenting