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This volume presents a timely account of the present state of ECT research and clinical practice and the irreplaceable niche ECT occupies in the treatment hierarchy of severe mental illness. Interdisciplinary contributors to The Clinical Science of Electroconvulsive Therapy use both longitudinal and cross-sectional perspectives to synthesize the latest information on ECT. This book reviews—comprehensively and carefully—today's knowledge of indications, techniques, clinical outcomes, and mechanisms of action of ECT.
The student and psychiatric resident, as well as the experienced clinician and researcher, will be reassured in reading these chapters that progress in ECT has been remarkable despite a notable lack of support among their peers and the public. Readers will be reminded that ECT remains alive and well in the hands of the sophisticated few.
The New Clinical Science of ECT. Who should get ECT? ECT technique: electrode placement, stimulus type, and treatment frequency. ECT stimulus dosing: relations to efficacy and adverse effects. Clinical and laboratory predictors of ECT response. Structural brain imaging and ECT. EEG monitoring of ECT seizures. Hemispheric components of ECT response in mood disorders and schizophrenia. ECT and memory. Continuation and maintenance therapy with outpatient ECT. ECT in Special Patient Populations. ECT in medically ill patients. ECT as a treatment for neurologic illness. Mechanisms. The neurobiology of ECT: animal studies. Antidepressant action and the neurobiologic effects of ECT: human studies.