Biological treatments: Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Light therapy

Size: px
Start display at page:

Download "Biological treatments: Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Light therapy"

Transcription

1 Biological treatments: Electroconvulsive Therapy, Transcranial Magnetic Stimulation, Light therapy Basic trainee talk 23 May 2007

2 ECT

3 When is ECT used. Depression. Severe, melancholic. Resistant to treatment. Treatment options not tolerated, or higher risk Patient preference. Mania Acute relapse schizophrenia, esp. catatonia. Neurological disorders, esp. Parkinson's & status epilepticus.

4 Evidence for ECT Depression. Six meta-analyses Mania ECT > sham ECT ECT > medications (TCA, MAOI, paroxetine) ECT > rtms Open trials Schizophrenia Open trials ECT < antipsychotics.

5

6 Cognitive effects Acute Confusion. Disorientation Up to four weeks Measured as Time to reorientation or time to talking. Decreased learning of new material Longer term? Loss of autobiographical material.

7 Reduction of side effects and effect. Placement Right Unilateral (RUL) Bilateral Bifrontal Dosage 2-3x threshold 6-8x threshold Fixed Type current Sine Square Sine worse than square. Low dose less effective, less side effects Bilateral more effective, more side effects 6x as effective as 2x but less side effects.

8 Long term effects. Naturalistic trial 375 patients, 9 centres. 2 using sine wave machine has more cog. side effects (also fixed dosing) Site mattered more than type. Bilateral lead to more autobiographical memory losses. Some memory loss persisted for six months.

9 What ECT now involves A brief anaesthetic (including paralysis) EEG (brainwave) monitoring. ECG (heartbeat) monitoring. Use of minimal dose of electricity to cause an effective seizure. Monitoring clinical outcome.

10 ECT in Australia & New Zealand. RANZCP guidelines ECT mandate: Levels of equipment. Supervision by consultant psychiatrist and consultant anaesthetist All trainees must. be aware of the nature of ECT Seriousness of ECT Experience of patients undergoing ECT. Treat 10 patients under supervision, using a stimulus titration method.

11 Rate of ECT use. per population. New Zealand 8 Scotland 19.7 Wales 22 Victoria (Australia) 44 Queensland (Australia) 34 Western Australia 14 From Melding, NZMJ 2006

12 Consent for ECT. Consent Must include giving information in writing. If unable to consent. If is not mentally disordered (in terms mental health act), cannot treat. If is mentally disordered, cannot treat without second opinion that in patients' best interests. This opinion can only be given by those approved by the (National) MHA review tribunal.

13 Research. Most recent meta-analysis ( J ECT, 1995) Efficacy when compared to: Placebo Sham ECT. Cognition testing improves with ECT (AREAN data, unpublished. There are at times loss of declarative memory. 85% of psychiatrists would receive ECT if depressed (Scot Med J, 2007)

14 ECT and BDNF

15 Patient's attitudes to ECT (Mayo Clinic Proc 1999)

16 ECT v rtms Am J Psychiatry 164:73-81, January 2007

17 ECT vs rtms Biol Psychiatry Apr 15;51(8):

18 ECT vs rtms The International Journal of Neuropsychopharmacology, Volume 9, Issue 06, December 2006, pp This paper found no significant difference between rtms and ECT in HAM-D scores However, more people who had ECT (white boxes) remitted.

19 Cognitive side effects ECT and rtms

20 ECT and death Br J Psychiatry April 2007

21 ECT and suicide

22 Suggestions. ECT remains useful as a treatment. Like all psychiatric treatments, it has side effects. The safeguards within the current system are not perfect, but good enough We are probably too cautious in using ECT. Removal of ECT as an option is highly likely to be life threatening for profoundly depressed and catatonic patients.

23 rtms

24 Repetitive transcranial magnetic stimulation. Newer technique. Recurrent stimulation over a period of time. Multiple sessions.

25 Depression: rtms vs sham rtms Am J Psychiatry Jan;163(1):88-94.

26 Treatment resistant depression: sham rtms vs TMS Biol Psychiatry Jan 15;59(2):187-94

27 Response and remission in treatment resistant depression: rtms vs TMS

28 Bipolar depression rtms vs sham Bipolar disorder (1) 40-47

29 Meta analysis The International Journal of Neuropsychopharmacology, Volume 9, Issue 06, December 2006, pp

30 Predictors response to rtms

31 Response and remission rate rtms

32 Light box

33 Light therapy Bright natural light, full spectrum ie lumens, about 40 cm away from face, for 30 minutes a day. Generally used seasonal affective disorder. Common use at high latitudes: Canada, Minnesota, New York etc Scotland Scandinavia

34 Light therapy vs fluoxetine Am J Psychiatry May;163(5):

35 Use light therapy Uncertain in Dunedin (45 S). Common in Canada (55 N) and Scandinavia (50 N). In winter, it is light 9am 3 pm. In winter, light 11 am 1 pm. Is advising people to walk outside at lunchtime cheaper and as effective? Issue of quality of light? Would data vary geographically? No known data NZ.

The New Clinical Science of ECT

The New Clinical Science of ECT The New Clinical Science of ECT C. Edward Coffey, MD Professor of Psychiatry & Behavioral Sciences, and of Neurology Baylor College of Medicine Houston, Texas Fellow and Past President, International Society

More information

Neuromodulation Approaches to Treatment Resistant Depression

Neuromodulation Approaches to Treatment Resistant Depression 1 Alternative Treatments: Neuromodulation Approaches to Treatment Resistant Depression Audrey R. Tyrka, MD, PhD Assistant Professor Brown University Department of Psychiatry Associate Chief, Mood Disorders

More information

Psychopharmacology 1: ECT

Psychopharmacology 1: ECT Psychopharmacology 1: ECT Paul Glue paul.glue@otago.ac.nz August 2017 How do antidepressants work? Early theories neurotransmitter deficiency - Unable to demonstrate; doesn t account for diversity of antidepressant

More information

ECT: an update. Grand Round 26 May Chris Gale. Local audit data: Sebastian Alverez-Grandi Paul Glue

ECT: an update. Grand Round 26 May Chris Gale. Local audit data: Sebastian Alverez-Grandi Paul Glue ECT: an update. Grand Round 26 May 2017 Chris Gale. Local audit data: Sebastian Alverez-Grandi Paul Glue Experience with ECT. l l l l 1987: as SHO, gave ECT while on call. One session teaching. 1992: as

More information

Objectives. Objectives. A practice review. 02-Nov-16 MAJOR DEPRESSIVE DISORDER: NEW DEVELOPMENTS AND PRACTICAL IMPLICATIONS

Objectives. Objectives. A practice review. 02-Nov-16 MAJOR DEPRESSIVE DISORDER: NEW DEVELOPMENTS AND PRACTICAL IMPLICATIONS MAJOR DEPRESSIVE DISORDER: NEW DEVELOPMENTS AND PRACTICAL IMPLICATIONS Jon-Paul Khoo What is treatment resistance really? Database review 328 consecutive non-remitted MDD patients referred for private

More information

Are they still doing that?

Are they still doing that? Are they still doing that? Why we still give ECT and when to refer Nicol Ferrier BSc (Hons), MD, FRCP(Ed), FRCPsych Emeritus Professor of Psychiatry Newcastle University Rates of prescribing ECT in the

More information

Electro-Convulsive Therapy Goals. Electro-Convulsive Therapy: Update Ambulatory Surgery Center at UCSF. Outline

Electro-Convulsive Therapy Goals. Electro-Convulsive Therapy: Update Ambulatory Surgery Center at UCSF. Outline : Update 2008 Descartes Li, M.D. Associate Clinical Professor Department of Psychiatry University of California, San Francisco Goals By the end of the seminar, a participant should be able to: Describe

More information

Statement on Electroconvulsive Therapy (ECT) Position statement CERT01/17

Statement on Electroconvulsive Therapy (ECT) Position statement CERT01/17 Statement on Electroconvulsive Therapy (ECT) Position statement CERT01/17 Approved by the Royal College of Psychiatrists, Committee on ECT and Related Treatments: February 2017 Disclaimer: This guidance

More information

BRAIN STIMULATION AN ALTERNATIVE TO DRUG THERAPY IN MATERNAL DEPRESSION?

BRAIN STIMULATION AN ALTERNATIVE TO DRUG THERAPY IN MATERNAL DEPRESSION? BRAIN STIMULATION AN ALTERNATIVE TO DRUG THERAPY IN MATERNAL DEPRESSION? Kira Stein, MD Medical Director West Coast Life Center Sherman Oaks, California CA Maternal Mental Health Initiative - 2013 2013

More information

Repetitive transcranial magnetic stimulation for depression

Repetitive transcranial magnetic stimulation for depression NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Repetitive transcranial magnetic stimulation for depression Depression causes low mood or sadness that can

More information

rtms Versus ECT The Future of Neuromodulation & Brain Stimulation Therapies

rtms Versus ECT The Future of Neuromodulation & Brain Stimulation Therapies rtms Versus ECT The Future of Neuromodulation & Brain Stimulation Therapies rtms Treatment Equipment rtms Equipment Positioning of coil ECT & rtms Innovative Treatment Options for Patients Only a fraction

More information

The Next Chapter in Brain Stimulation Therapy

The Next Chapter in Brain Stimulation Therapy The Next Chapter in Brain Stimulation Therapy Outline I. Depression and Treatment Resistant Depression Barriers to Treatment Treatment Options Cost and Impact of Depression II. Electroconvulsive Therapy

More information

When & How to Use ECT in Older Adults. Frans Hugo SJOG Midland Hospital, PERTH

When & How to Use ECT in Older Adults. Frans Hugo SJOG Midland Hospital, PERTH When & How to Use ECT in Older Adults Frans Hugo SJOG Midland Hospital, PERTH Frans.Hugo@sjog.org.au When to Use Most effective and rapid treatment for elderly with severe MDD, bipolar mania, bipolar depression

More information

Statement on Repetitive Transcranial Magnetic Stimulation for Depression. Position statement CERT03/17

Statement on Repetitive Transcranial Magnetic Stimulation for Depression. Position statement CERT03/17 Statement on Repetitive Transcranial Magnetic Stimulation for Depression Position statement CERT03/17 Approved by the Royal College of Psychiatrists, Committee on ECT and Related Treatments: February 2017

More information

ECT in Schizophrenia. Dr Richard Braithwaite Consultant Psychiatrist Isle of Wight NHS Trust

ECT in Schizophrenia. Dr Richard Braithwaite Consultant Psychiatrist Isle of Wight NHS Trust ECT in Schizophrenia Dr Richard Braithwaite Consultant Psychiatrist Isle of Wight NHS Trust ECT in Schizophrenia (not catatonia) Dr Richard Braithwaite Consultant Psychiatrist Isle of Wight NHS Trust Objectives

More information

Summary of guideline for the. treatment of depression RANZCP CLINICAL PRACTICE GUIDELINES ASSESSMENT

Summary of guideline for the. treatment of depression RANZCP CLINICAL PRACTICE GUIDELINES ASSESSMENT RANZCP CLINICAL PRACTICE GUIDELINES Summary of guideline for the RANZCP CLINICAL PRACTICE GUIDELINES treatment of depression Pete M. Ellis, Ian B. Hickie and Don A. R. Smith for the RANZCP Clinical Practice

More information

Electroconvulsive therapy and its place in the management of depression Ankush Singhal MD, MRCPsych

Electroconvulsive therapy and its place in the management of depression Ankush Singhal MD, MRCPsych ECT for depression z Review Electroconvulsive therapy and its place in the management of depression Ankush Singhal MD, MRCPsych Electroconvulsive therapy (ECT) is a psychiatric treatment with a controversial

More information

ECT in children and adolescents

ECT in children and adolescents ECT in children and adolescents Adi Sharma MD MRCPsych PhD Clinical Senior Lecturer & Hon Consultant in Child & Adolescent Psychiatry National Adolescent Bipolar Service 1 Conflicts None relevant to this

More information

Help and Healing: Section 2: Treatment Planning. Treatment and Timelines. Depression Treatment Reference. Care Team Communication

Help and Healing: Section 2: Treatment Planning. Treatment and Timelines. Depression Treatment Reference. Care Team Communication Help and Healing: Resources for Depression Care and Recovery Section 2: Treatment Planning Treatment and Timelines Depression Treatment Reference Care Team Communication Provider Education Tool - Questions

More information

Electro-convulsive Therapy (ECT) Your questions answered

Electro-convulsive Therapy (ECT) Your questions answered Electro-convulsive Therapy (ECT) Your questions answered Q A Welcome This leaflet aims to answer some of the questions you may have about Electro-convulsive Therapy (ECT). You may wish to know why ECT

More information

Clinical Fellowship for TMS/Inpatient Services/ Mood Disorders Program/ ECT -Electroconvulsive Therapy (TIME)

Clinical Fellowship for TMS/Inpatient Services/ Mood Disorders Program/ ECT -Electroconvulsive Therapy (TIME) Clinical Fellowship for TMS/Inpatient Services/ Mood Disorders Program/ ECT -Electroconvulsive Therapy (TIME) Name of Institution: Location: Number of positions: McGill University Health Centre Montreal

More information

Transcranial Magnetic Stimulation for the Treatment of Depression

Transcranial Magnetic Stimulation for the Treatment of Depression Transcranial Magnetic Stimulation for the Treatment of Depression Paul E. Holtzheimer, MD Associate Professor Departments of Psychiatry and Surgery Geisel School of Medicine at Dartmouth Dartmouth-Hitchcock

More information

Depression. University of Illinois at Chicago College of Nursing

Depression. University of Illinois at Chicago College of Nursing Depression University of Illinois at Chicago College of Nursing 1 Learning Objectives Upon completion of this session, participants will be better able to: 1. Recognize depression, its symptoms and behaviors

More information

BILATERAL ECT TREATMENT PROTOCOL FOR THE THYMATRON IV Method 1 preferred method to minimise cognitive side-effects.

BILATERAL ECT TREATMENT PROTOCOL FOR THE THYMATRON IV Method 1 preferred method to minimise cognitive side-effects. BILATERAL ECT TREATMENT PROTOCOL FOR THE THYMATRON IV Method 1 preferred method to minimise cognitive side-effects. 1. Measure seizure threshold (ST) in millicoulombs (mc) Set machine at level 2 = 10%

More information

Information about ELECTROCONVULSIVE THERAPY (ECT)

Information about ELECTROCONVULSIVE THERAPY (ECT) Information om behandling med ECT For adults Information about ELECTROCONVULSIVE THERAPY (ECT) Psykiatri og Social psykinfomidt.dk CONTENTS 03 What is ECT? 03 Who can have ECT treatment? 05 How does ECT

More information

THE PRACTICE OF ECT. Kiran Rabheru

THE PRACTICE OF ECT. Kiran Rabheru THE PRACTICE OF ECT Kiran Rabheru MD, CCFP, FRCP Geriatric Psychiatrist Professor University of Ottawa February 11, 2015 U of Ottawa Review Course in Psychiatry: Dr. K. Rabheru 1 Disclosures n NONE 2 Learning

More information

Does Criticism of Electroconvulsive Therapy undermines its benefits: A Critical Review of its Cognitive Adverse Effects

Does Criticism of Electroconvulsive Therapy undermines its benefits: A Critical Review of its Cognitive Adverse Effects Commentary Does Criticism of Electroconvulsive Therapy undermines its benefits: A Critical Review of its Cognitive Adverse Effects A Rajendran, 1 VS Grewal, 2 Jyoti Prakash 3 1 Department of Psychiatry,

More information

Clinical Perspective on Conducting TRD Studies. Hans Eriksson, M.D., Ph.D., M.B.A. Chief Medical Specialist, H. Lundbeck A/S Valby, Denmark

Clinical Perspective on Conducting TRD Studies. Hans Eriksson, M.D., Ph.D., M.B.A. Chief Medical Specialist, H. Lundbeck A/S Valby, Denmark Clinical Perspective on Conducting TRD Studies Hans Eriksson, M.D., Ph.D., M.B.A. Chief Medical Specialist, H. Lundbeck A/S Valby, Denmark Overview of Presentation Treatment-Resistant Depression (TRD)

More information

Charles H. Kellner, MD

Charles H. Kellner, MD ECT: Learning From Recent Trials Charles H. Kellner, MD Professor, Department of Psychiatry Icahn School of Medicine at Mount Sinai ISCTM Philadelphia, PA 27 September, 2016 Charles H. Kellner, MD Disclosures

More information

Patient Manual Brainsway Deep Transcranial Magnetic Stimulation (Deep TMS) System for Treatment of Major Depressive Disorder

Patient Manual Brainsway Deep Transcranial Magnetic Stimulation (Deep TMS) System for Treatment of Major Depressive Disorder Dr. Zahida Tayyib www.mvptms.com Patient Manual Brainsway Deep Transcranial Magnetic Stimulation (Deep TMS) System for Treatment of Major Depressive Disorder If you are considering Brainsway Deep treatment

More information

Mayo Clin Proc, June 2002, Vol 77 Treatment of Medication-Refractory Mental Illness 553 Figure 1. Bitemporal electrode placement (left), unilateral el

Mayo Clin Proc, June 2002, Vol 77 Treatment of Medication-Refractory Mental Illness 553 Figure 1. Bitemporal electrode placement (left), unilateral el 552 Concise Review for Clinicians Electroconvulsive Therapy and Newer Modalities for the Treatment of Medication-Refractory Mental Illness KEITH G. RASMUSSEN, MD; SHIRLENE M. SAMPSON, MD; AND TERESA A.

More information

Alcohol Opiates Other:

Alcohol Opiates Other: Pages 1 and 2 must be completed in full for all referrals (incomplete forms will not be processed) Additional Required Information Form must be completed for all referrals Medication Clinic (Pg. 3), ECT

More information

Administration of repetitive transcranial magnetic stimulation (rtms)

Administration of repetitive transcranial magnetic stimulation (rtms) Professional Practice Guideline 16 Administration of repetitive transcranial magnetic stimulation (rtms) November 2018 Authorising Body: Responsible Committee/Department: Responsible Department: Document

More information

ª The Author(s) The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie 1-15

ª The Author(s) The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie 1-15 Canadian Psychiatric Association Association des psychiatres du Canada Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive

More information

IEHP UM Subcommittee Approved Authorization Guidelines Electroconvulsive Therapy- ECT

IEHP UM Subcommittee Approved Authorization Guidelines Electroconvulsive Therapy- ECT Electroconvulsive Therapy- ECT Policy: IEHP considers ECT medically necessary for members with the following disorders: 1. Unipolar and bipolar depression. 2. Bipolar mania. 3. Psychotic disorders including

More information

ADMINISTRATIVE POLICY AND PROCEDURE

ADMINISTRATIVE POLICY AND PROCEDURE Page 1 of 6 SECTION: Medical SUBJECT: Electroconvulsive Therapy (ECT) DATE OF ORIGIN: 10/1/96 REVIEW DATES: 7/1/98, 10/1/99, 7/1/02, 7/1/04, 10/1/05, 5/1/09, 1/3/13, 7/1/15, 8/1/16 EFFECTIVE DATE: 3/24/17

More information

Practice Guideline for the Treatment of Patients With Major Depressive Disorder: American Psychiatric Association

Practice Guideline for the Treatment of Patients With Major Depressive Disorder: American Psychiatric Association Practice Guideline for the Treatment of Patients With Major Depressive Disorder: American Psychiatric Association Our clinical advisor adds updated advice on electroconvulsive therapy, transcranial magnetic

More information

Brain Stimulation. Berry S. Anderson, PhD, RN Mary Rosedale, PhD, PMHNP-BC, NEA-BC Theresa Kormos, PMHCNS-BC Cindy Brown, BSN, RN

Brain Stimulation. Berry S. Anderson, PhD, RN Mary Rosedale, PhD, PMHNP-BC, NEA-BC Theresa Kormos, PMHCNS-BC Cindy Brown, BSN, RN Brain Stimulation American Psychiatric Nurses Association 24th Annual Conference October 16, 2010 Kentucky International Convention Center Louisville, Kentucky 1 Berry S. Anderson, PhD, RN Mary Rosedale,

More information

Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy

Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy ANZJP ArticlesWeiss et al. 839139ANP RANZCP Guidelines Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy Australian

More information

PRACTICAL MANAGEMENT OF DEPRESSION IN OLDER ADULTS. Lee A. Jennings, MD MSHS Assistant Professor Division of Geriatrics, UCLA

PRACTICAL MANAGEMENT OF DEPRESSION IN OLDER ADULTS. Lee A. Jennings, MD MSHS Assistant Professor Division of Geriatrics, UCLA CASE #1 PRACTICAL MANAGEMENT OF DEPRESSION IN OLDER ADULTS Lee A. Jennings, MD MSHS Assistant Professor Division of Geriatrics, UCLA OBJECTIVES Epidemiology Presentation in older adults Assessment Treatment

More information

Treatment-resistant depression in primary care

Treatment-resistant depression in primary care Treatment-resistant depression in primary care Interprofessional CME, October 2017 Brian J. Mickey, MD, PhD Associate Professor School of Medicine Department of Psychiatry Disclosures Speakers bureau:

More information

The use of electroconvulsive therapy

The use of electroconvulsive therapy NHS National Institute for Clinical Excellence The use of electroconvulsive therapy Understanding NICE guidance information for service users, their advocates and carers, and the public April 2003 The

More information

VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT)

VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT) VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT) Diagnostic Guidelines: Introduction: Electroconvulsive Therapy has been in continuous use for more than 60 years. The clinical literature

More information

Psychiatry curbside: Answers to a primary care doctor s top mental health questions

Psychiatry curbside: Answers to a primary care doctor s top mental health questions Psychiatry curbside: Answers to a primary care doctor s top mental health questions April 27, 2018 Laurel Ralston, DO Psychiatrist, Taussig Cancer Institute Objectives Review current diagnostic and prescribing

More information

What is Repetitive Transcranial Magnetic Stimulation?

What is Repetitive Transcranial Magnetic Stimulation? rtms for Refractory Depression: Findings and Future Jonathan Downar, MD PhD Asst Professor, Dept of Psychiatry University of Toronto, Canada Co-Director, rtms Clinic Toronto Western Hospital University

More information

Diagnosis & Management of Major Depression: A Review of What s Old and New. Cerrone Cohen, MD

Diagnosis & Management of Major Depression: A Review of What s Old and New. Cerrone Cohen, MD Diagnosis & Management of Major Depression: A Review of What s Old and New Cerrone Cohen, MD Why You re Treating So Much Mental Health 59% of Psychiatrists Are Over the Age of 55 AAMC 2014 Physician specialty

More information

Transcranial Direct-Current Stimulation

Transcranial Direct-Current Stimulation Introduction (tdcs) is a non-invasive form of brain stimulation similar to transcranial magnetic stimulation, but instead of using magnets, it uses a lowintensity, constant current applied through scalp

More information

arxiv: v1 [q-bio.nc] 9 Dec 2011

arxiv: v1 [q-bio.nc] 9 Dec 2011 Long Brief Pulse Method for Pulse-wave modified Electroconvulsive Therapy Hiroaki Inomata, 1,2,3, Hirohiko Harima, 1 and Masanari Itokawa 1,3 1 Tokyo Metropolitan Matsuzawa Hospital 2 Yokohama City University

More information

BRIEF SUMMARY CONTENT

BRIEF SUMMARY CONTENT Page 1 of 17 Brief Summary GUIDELINE TITLE Depression. The treatment and management of depression in adults. BIBLIOGRAPHIC SOURCE(S) National Collaborating Centre for Mental Health. Depression. The treatment

More information

FDA Executive Summary. Meeting to Discuss the Classification of Electroconvulsive Therapy Devices (ECT)

FDA Executive Summary. Meeting to Discuss the Classification of Electroconvulsive Therapy Devices (ECT) FDA Executive Summary Prepared for the January 27-28, 2011 meeting of the Neurological Devices Panel Meeting to Discuss the Classification of Electroconvulsive Therapy Devices (ECT) ECT 515(i) Executive

More information

Stage 2 General psychiatry EPAs & COE forms

Stage 2 General psychiatry EPAs & COE forms 2012 Fellowship Program Stage 2 General psychiatry EPAs & COE forms 309 La Trobe Street, Melbourne VIC 3000 Australia T +61 3 9640 0646 F +61 3 9642 5652 ranzcp@ranzcp.org www.ranzcp.org ABN 68 000 439

More information

Technology appraisal guidance Published: 26 April 2003 nice.org.uk/guidance/ta59

Technology appraisal guidance Published: 26 April 2003 nice.org.uk/guidance/ta59 Guidance on the use of electroconvulsive therapy Technology appraisal guidance Published: 26 April 2003 nice.org.uk/guidance/ta59 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).

More information

Postpartum Period. Dr Ann Roberts Consultant Psychiatrist

Postpartum Period. Dr Ann Roberts Consultant Psychiatrist ECT in Pregnancy and the Postpartum Period Dr Ann Roberts Consultant Psychiatrist Thumbswood MBU Hertfordshire ECT searches/overview of evidence e Medline, Embase, Psychinfo, Pubmed No prospective randomised

More information

KA-FAI CHUNG, mb bs, mrcpsych, fhkam Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China

KA-FAI CHUNG, mb bs, mrcpsych, fhkam Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China Psychiatry and Clinical Neurosciences (2002), 56, 521 526 Regular Article Relationships between seizure duration and seizure threshold and stimulus dosage at electroconvulsive therapy: Implications for

More information

Patient Education Brief. NeuroStar TMS Therapies

Patient Education Brief. NeuroStar TMS Therapies Patient Education Brief NeuroStar TMS Therapies Provided by Dr Terrence A. Boyadjis MD 790 E Market Street Suite 245 West Chester, PA 19382 610.738.9576 About Depression Depression is a serious medical

More information

2018 Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD Lundbeck, LLC.

2018 Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD Lundbeck, LLC. Neuromodulation Techniques: State of the Science Philip G. Janicak, MD Adjunct Professor Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine Consultant

More information

Electroconvulsive Therapy Audit Report

Electroconvulsive Therapy Audit Report Electroconvulsive Therapy Audit Report Published in March 2005 by the Ministry of Health PO Box 5013, Wellington, New Zealand ISBN 0-478-28345-8 (Website) HP 3821 This document is available on the Ministry

More information

Electroconvulsive therapy for depressive illness, schizophrenia, Health Technology Assessment 2005; Vol. 9: No. 9

Electroconvulsive therapy for depressive illness, schizophrenia, Health Technology Assessment 2005; Vol. 9: No. 9 Electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania:

More information

Abnormal Psychology Notes

Abnormal Psychology Notes Abnormal Psychology Notes Abnormal Behaviors Psychological Disorder a harmful dysfunction in which behavior is judged to be: atypical not enough in itself disturbing varies with time/culture maladaptive

More information

Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden

Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden Depression Research and Treatment Volume 2011, Article ID 470985, 7 pages doi:10.1155/2011/470985 Research Article Predictors of Time to Relapse/Recurrence after Electroconvulsive Therapy in Patients with

More information

Early Stages of Psychosis. Learning Objectives

Early Stages of Psychosis. Learning Objectives Early Stages of Psychosis Stephan Heckers, MD MSc Department of Psychiatry and Behavioral Sciences Vanderbilt University Learning Objectives Summarize the five domains of psychosis Describe how psychotic

More information

Electroconvulsive Therapy (ECT)

Electroconvulsive Therapy (ECT) Electroconvulsive Therapy (ECT) UHN Information for patients and families Read this booklet to learn: What ECT is and how it works How to prepare for the treatment What you can expect Some side effects

More information

Transcranial direct current stimulation (tdcs)

Transcranial direct current stimulation (tdcs) Clinical Memorandum Transcranial direct current stimulation (tdcs) August 2018 Authorising Committee/Department: Responsible Committee Responsible Department: Document Code: Board Section of Electroconvulsive

More information

ECT Seizure Duration: Database Information

ECT Seizure Duration: Database Information Reprinted from the German Journal of Psychiatry http://www.gjpsy.uni-goettingen.de ISSN 1433-1055 ECT Seizure Duration: Database Information Saxby Pridmore 1, Gaye Batt 2, and Hakuei Fujiyama 3 1 University

More information

Lithium in bipolar disorders.

Lithium in bipolar disorders. Lithium in bipolar disorders. S. Mehdi Samimi Ardestani M.D. Department of Psychiatry, Shahid Beheshti University of Medical Science, Behavioral science research center Iranian psychiatric association,

More information

Case 2:15-cv MWF-JPR Document Filed 03/20/17 Page 1 of 36 Page ID #:388 EXHIBIT 1

Case 2:15-cv MWF-JPR Document Filed 03/20/17 Page 1 of 36 Page ID #:388 EXHIBIT 1 Case 2:15-cv-07074-MWF-JPR Document 65-10 Filed 03/20/17 Page 1 of 36 Page ID #:388 EXHIBIT 1 Case 2:15-cv-07074-MWF-JPR Document 65-10 Filed 03/20/17 Page 2 of 36 Page ID #:389 Cigna Medical Coverage

More information

Electroconvulsive Therapy (ECT) Patient Information Leaflet

Electroconvulsive Therapy (ECT) Patient Information Leaflet Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. This information can be made available in a range of formats

More information

Keith G. Rasmussen, MD Mayo Clinic Department of Psychiatry Rochester, Minnesota, USA

Keith G. Rasmussen, MD Mayo Clinic Department of Psychiatry Rochester, Minnesota, USA Keith G. Rasmussen, MD Mayo Clinic Department of Psychiatry Rochester, Minnesota, USA rasmussen.keith@mayo.edu Why is lithium important? Effective for all stages of bipolar disorder acute treatment as

More information

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) Transcranial Magnetic Stimulation (TMS) The treatment coil produces MRI-strength magnetic field pulses. Magnetic field pulses pass unimpeded through the cranium for 2-3 cm. and induce a small electric

More information

Guidance on the use of electroconvulsive therapy

Guidance on the use of electroconvulsive therapy NHS National Institute for Clinical Excellence Guidance on the use of electroconvulsive therapy Technology Appraisal 59 April 2003 Technology Appraisal Guidance 59 Guidance on the use of electroconvulsive

More information

Interventions for Relapsing Depression: TMS, ECT, and Ketamine

Interventions for Relapsing Depression: TMS, ECT, and Ketamine Interventions for Relapsing Depression: TMS, ECT, and Ketamine MDD top cause of disability; suicide only top-10 cause of death currently increasing. 10-15% lifetime prevalence A third of patients do not

More information

Public Perception of ECT

Public Perception of ECT ECT as a Therapeutic Option in Older Adults Dr. Mark Strazisar March 1, 2018 Public Perception of ECT 1 The Reality of ECT Objectives By the end of this lecture, the medical professional shall demonstrate

More information

Major Depression and Anxiety in Adolescents and Adults

Major Depression and Anxiety in Adolescents and Adults Major Depression and Anxiety in Adolescents and Adults Miggie Greenberg, M.D. Associate Professor of Psychiatry St. Louis University School of Medicine greenbml@slu.edu *NO DISCLOSURES* OBJECTIVES * Recognize

More information

Mental Health Commission Rules

Mental Health Commission Rules Mental Health Commission Rules Reference Number: R-S59(2)/01/2006 RULES GOVERNING THE USE OF ELECTRO-CONVULSIVE THERAPY 1 st November 2006 PREAMBLE Section 59 of the Mental Health Act 2001 obliges the

More information

Interventions for Relapsing Depression: TMS, ECT, and Ketamine

Interventions for Relapsing Depression: TMS, ECT, and Ketamine Interventions for Relapsing Depression: TMS, ECT, and Ketamine MDD top cause of disability; suicide only top-10 cause of death currently increasing. 10-15% lifetime prevalence A third of patients do not

More information

Your footnote

Your footnote MANIA Your footnote Your footnote Cipriani A, Barbui C, Salanti G et al. Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis. The Lancet 2011;

More information

Future directions and development in ECT technique May Martin Balslev Jørgensen

Future directions and development in ECT technique May Martin Balslev Jørgensen Future directions and development in ECT technique May 2014 Martin Balslev Jørgensen Research trends Side effects Augmentation Maintenance Other Brain Stimulation approaches Side Effects Dosing strategies

More information

Original Effective Date: 8/28/2013. Subject: Transcranial Magnetic Stimulation for the Treatment of Major Depression

Original Effective Date: 8/28/2013. Subject: Transcranial Magnetic Stimulation for the Treatment of Major Depression Subject: Transcranial Magnetic Stimulation for the Treatment of Major Depression Guidance Number: MCG-104 Revision Date(s): Original Effective Date: 8/28/2013 Medical Coverage Guidance Approval Date: 8/28/2013

More information

Practice parameter for use of electroconvulsive therapy with adolescents.

Practice parameter for use of electroconvulsive therapy with adolescents. Complete Summary GUIDELINE TITLE Practice parameter for use of electroconvulsive therapy with adolescents. BIBLIOGRAPHIC SOURCE(S) Ghaziuddin N, Kutcher SP, Knapp P, Bernet W, Arnold V, Beitchman J, Benson

More information

LIMITATIONS OF MOTOR SEIZURE MONITORING IN ECT

LIMITATIONS OF MOTOR SEIZURE MONITORING IN ECT Indian J. Psychiat, 1998, 40 (1), 55-59 LIMITATIO OF MOTOR SEIZURE MONITORING IN ECT M.S. JAYAPRAKASH, B.N. GANGADHAR, N. JANAKIRAMAIAH & D.K. SUBBAKRISHNA ABSTRACT Seizures were monitored using both cuff

More information

LEASE DO NOT COPY. Setting up atms Clinic

LEASE DO NOT COPY. Setting up atms Clinic Setting up atms Clinic Daniel Press, M.D. Assistant Professor in Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center Contents Safety and training of personnel Equipment Certification

More information

For many patients with neuropsychiatric illnesses, standard

For many patients with neuropsychiatric illnesses, standard INVITED REVIEW Multifactorial Determinants of the Neurocognitive Effects of Electroconvulsive Therapy Shawn M. McClintock, MSCS, PhD,* Jimmy Choi, PsyD, Zhi-De Deng, PhD,* Lawrence G. Appelbaum, PhD,*

More information

Electroconvulsive Therapy (ECT) Patient Guide

Electroconvulsive Therapy (ECT) Patient Guide Electroconvulsive Therapy (ECT) Patient Guide February 2015 This booklet has the information you need to give an informed consent for Electroconvulsive Therapy (ECT). You learn what ECT is, the purpose

More information

Information for patients, families and caregivers

Information for patients, families and caregivers Depression Information for patients, families and caregivers Read this booklet to learn: what depression is what causes it the signs or symptoms of depression what treatments can help Please visit the

More information

Dementia With A Twist

Dementia With A Twist Dementia With A Twist Christina Tieu Geriatric Update for the Primary Care Provider November 17 th, 2016 2016 MFMER slide-1 79 y/o woman originally from Greece CC: paranoia, abulia and mutism Accompanied

More information

Treatment Options for Bipolar Disorder Contents

Treatment Options for Bipolar Disorder Contents Keeping Your Balance Treatment Options for Bipolar Disorder Contents Medication Treatment for Bipolar Disorder 2 Page Medication Record 5 Psychosocial Treatments for Bipolar Disorder 6 Module Summary 8

More information

Please read the following important safety requirements before using the Thymatron System IV ECT Instrument.

Please read the following important safety requirements before using the Thymatron System IV ECT Instrument. Caution: Federal law restricts this device to sale by or on the order of a licensed physician. ECT is a complex medical procedure. Its proper and safe conduct requires a staff of licensed healthcare professionals

More information

Depressive, Bipolar and Related Disorders

Depressive, Bipolar and Related Disorders Depressive, Bipolar and Related Disorders Robert Kelly, MD Assistant Professor of Psychiatry Weill Cornell Medical College White Plains, New York Lecture available at www.robertkelly.us Financial Conflicts

More information

Electroconvulsive Therapy (ECT) Patient Information Leaflet

Electroconvulsive Therapy (ECT) Patient Information Leaflet Electroconvulsive Therapy (ECT) Patient Information Leaflet Contents Page Introduction 3 What is Electroconvulsive Therapy (ECT)? 3 Why has ECT been recommended? 3 What will happen if I have ECT? 3-4 How

More information

Aiming for recovery for patients with severe or persistent depression a view from secondary care. Chrisvan Koen

Aiming for recovery for patients with severe or persistent depression a view from secondary care. Chrisvan Koen Aiming for recovery for patients with severe or persistent depression a view from secondary care Chrisvan Koen Kent and Medway NHS and Social care Partnership trust Persistent depressive disorder F34 Persistent

More information

Some newer, investigational approaches to treating refractory major depression are being used.

Some newer, investigational approaches to treating refractory major depression are being used. CREATED EXCLUSIVELY FOR FINANCIAL PROFESSIONALS Rx FOR SUCCESS Depression and Anxiety Disorders Mood and anxiety disorders are common, and the mortality risk is due primarily to suicide, cardiovascular

More information

Kelly Godecke, MD Department of Psychiatry University of Utah

Kelly Godecke, MD Department of Psychiatry University of Utah Kelly Godecke, MD Department of Psychiatry University of Utah Epidemiology and Impact -module 2 session 1 overview of mood disorders Diagnostic Criteria of Bipolar Disorders Medications Used in Bipolar

More information

Repetitive Transcranial Magnetic Stimulation (rtms)

Repetitive Transcranial Magnetic Stimulation (rtms) Page 1 of 33 Medical Policies - Mental Health Repetitive Transcranial Magnetic Stimulation (rtms) Print Number: PSY301.015 Effective Date: 07-01-2014 Coverage: Initial rtms Treatment Repetitive transcranial

More information

Neuro-MS/D DIAGNOSTICS REHABILITATION TREATMENT STIMULATION. Transcranial Magnetic Stimulator. of motor disorders after the stroke

Neuro-MS/D DIAGNOSTICS REHABILITATION TREATMENT STIMULATION. Transcranial Magnetic Stimulator. of motor disorders after the stroke Neuro-MS/D Transcranial Magnetic Stimulator DIAGNOSTICS of corticospinal pathway pathology REHABILITATION of motor disorders after the stroke TREATMENT of depression and Parkinson s disease STIMULATION

More information

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation Transcranial Magnetic Stimulation Date of Origin: 7/24/2018 Last Review Date: 7/24/2018 Effective Date: 08/01/18 Dates Reviewed: 7/24/2018 Developed By: Medical Necessity Criteria Committee I. Description

More information

ELECTROCONVULSIVE THERAPY (ECT)

ELECTROCONVULSIVE THERAPY (ECT) ELECTROCONVULSIVE THERAPY (ECT) Optum Behavioral Clinical Policy Policy Number: BH727ECTBCP_032017 Effective Date: March, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS...

More information

Electroconvulsive Therapy (ECT) Patient Information Leaflet

Electroconvulsive Therapy (ECT) Patient Information Leaflet Electroconvulsive Therapy (ECT) Patient Information Leaflet 2 Contents Page Introduction 3 What is Electroconvulsive Therapy (ECT)? 3 Why has ECT been recommended? 3 What will happen if I have ECT? 3-4

More information

Name: Period: Chapter 14 Reading Guide Psychological Disorders

Name: Period: Chapter 14 Reading Guide Psychological Disorders Name: Period: Chapter 14 Reading Guide Psychological Disorders Introduction to Psychological Disorders (pg. 593-600) 1. List AND describe the 3 definitions of abnormal. A. Understanding Psychological Disorders

More information

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A

Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Is Depression management getting you down? G. Michael Allan Director Programs and Practice Support, CFPC Professor, Family Med, U of A Faculty/Presenter Disclosures Faculty: Mike Allan Salary: College

More information