Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: smart on 24/08/2017 12:37:47
-
I'm interested to understand the rationale of electroconvulsive therapy (ECT) for schizophrenia. ECT may be utterly dangerous and can cause permanent brain damage. Why do people accept this inhuman treatment?
What do you think?
-
I'm interested to understand the rationale of electroconvulsive therapy (ECT) for schizophrenia.
It's primarily an option that follows an inadequate response to antipsychotic medications in patients with catatonic schizophrenia.
The literature does demonstrate some degree of efficacy, but the risks are definitely well-established.
-
It's primarily an option that follows an inadequate response to antipsychotic medications in patients with catatonic schizophrenia.
The literature does demonstrate some degree of efficacy, but the risks are definitely well-established.
Thanks for sharing exothermic, but you didn't answer my initial question yet. Can you please tell me by yes or no if such "treatment" is punitive?
-
Is electroconvulsive therapy for schizophrenia a punitive treatment?
No
It's therapeutic.
-
Is electroconvulsive therapy for schizophrenia a punitive treatment?
No
It's therapeutic.
Something that can cause permanent brain damage and memory loss is not therapeutic. You seem to forget that psychiatrists should NOT do any harm to their patients, unless they want to violate the hippocratic oath.
See: http://www.ect.org/?p=709
-
Can you please tell me by yes or no if such "treatment" is punitive
..... no
ECT augmentation has been continued ever since the re-introduction of clozapine in the 1990s and the effectiveness of ECT in patients on clozapine has been reported in two randomized controlled studies, as well as in case reports and open trials.
These studies consistently demonstrated favorable clinical effects and safety. In studies including a meta-analysis, 47.4 - 72.7% of patients with clozapine-resistant schizophrenia experienced clinical improvement after ECT.
PMCID: PMC5240461
Psychiatry Investig. 2017 Jan; 14(1): 58–62. Published online 2016 Dec 29. doi: 10.4306/pi.2017.14.1.58
Effectiveness of Electroconvulsive Therapy Augmentation on Clozapine-Resistant Schizophrenia
-
patients with catatonic schizophrenia
psychiatrists should NOT do any harm to their patients
Someone who is catatonic is doing themselves harm by inaction, at a slow and steady rate.
I expect psychiatrists would argue that "snapping them out of it" is a net benefit to the patient.
There is no doubt that ECT was used to excess in decades past - I know one guy (around 80 years old) who relates that as a young man he was given many treatments of ECT, seemingly without the clinical indications that are used today.
Many people's understanding of ECT probably arises from seeing the movie "One Flew Over the Cuckoo's Nest" - some suggest that widespread viewing of this movie forced changes in the practice of psychiatry. But there have been many other (http://www.listal.com/movies/electroshock+therapy) movies, with varying levels of gruesome portrayal.
See: The portrayal of ECT in American movies (https://www.ncbi.nlm.nih.gov/pubmed/11731728), but that is from a possibly biased source (The Journal of ECT).
-
Is electroconvulsive therapy for schizophrenia a punitive treatment?
No
It's therapeutic.
Something that can cause permanent brain damage and memory loss is not therapeutic.
You're taking things out of context again.
Brain surgery "can cause permanent brain damage and memory loss".
Is brain surgery a "punitive" treatment?
-
Is brain surgery a "punitive" treatment?
There's a huge difference between a brain surgery aimed to treat a PHYSICAL disease and a "treatment" used to directly damage the central nervous system beyond repair. ECT is without a doubt NOT therapeutic and probably used to intentionally harm the patient in hope to make him "normal" again.
-
ECT is without a doubt NOT therapeutic
.... lol
I'll try this again with bolded text:
"47.4 - 72.7% of patients with clozapine-resistant schizophrenia experienced clinical improvement"
-
and probably used to intentionally harm the patient in hope to make him "normal" again.
Did you recently watch Shutter Island by chance?
One Flew Over the Cuckoo's Nest maybe?
-
a "treatment" used to directly damage the central nervous system beyond repair.
Would you like to make any additional baseless/incorrect comments?
-
"Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder"
http://www.pnas.org/content/early/2012/03/12/1117206109.full.pdf+html
"For a long time now, I have been scientifically demonstrating that ECT is a closed-head injury in the form of an electrical lobotomy. Now we find that the ECT damage is sufficiently gross to show up on an MRI — but we are told it’s good for the patients. This is what I call “the brain-disabling principle of psychiatric treatment.” Lobotomy, ECT and psychiatric drugs all share the common factor that they “work” by damaging the brain and suppressing brain function."
http://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1373619.html
...
-
"Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder"
"For a long time now, I have been scientifically demonstrating that ECT is a closed-head injury in the form of an electrical lobotomy. Now we find that the ECT damage is sufficiently gross to show up on an MRI — but we are told it’s good for the patients. This is what I call “the brain-disabling principle of psychiatric treatment.” Lobotomy, ECT and psychiatric drugs all share the common factor that they “work” by damaging the brain and suppressing brain function."
Your thread title is exclusive to ECT in schizophrenic patients.....
Now you're trying to use a separate clinical entity to demonstrate your point.
Your example is exclusive to bilateral ECT & depression.
Show us how it applies to unilateral ECT in schizophrenia.
~
-
Show us how it applies to unilateral ECT in schizophrenia.
https://link.springer.com/article/10.1007/BF01074556
"Suicide after unilateral ect in a patient previously responsive to bilateral ect"
Is this how you define "clinical improvement" ?
-
Show us how it applies to unilateral ECT in schizophrenia.
https://link.springer.com/article/10.1007/BF01074556
"Suicide after unilateral ect in a patient previously responsive to bilateral ect"
Is this how you define "clinical improvement" ?
No.... That's what's called an insignificant case-study.
So how many more instances do you have to demonstrate a trend of increased suicide in schizophrenic patients receiving bilateral and/or bifrontal ECT?
-
"Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder"
http://www.pnas.org/content/early/2012/03/12/1117206109.full.pdf+html
"For a long time now, I have been scientifically demonstrating that ECT is a closed-head injury in the form of an electrical lobotomy. Now we find that the ECT damage is sufficiently gross to show up on an MRI — but we are told it’s good for the patients. This is what I call “the brain-disabling principle of psychiatric treatment.” Lobotomy, ECT and psychiatric drugs all share the common factor that they “work” by damaging the brain and suppressing brain function."
http://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1373619.html
lol..... What a load of crap.
The degree of cognitive disturbance would reflect the electrical current being utilized, as well as instrument-placement.
We're talking about therapy.... not punishment.
The safety of ECT:
In general, ECT is one of the best-tolerated biological therapies with low risk for severe complications, even lower than during the application of TC A.2,40 The mortality rate during ECT varies between 1:50 000 and 1:25 000 treatments.2,40 In less than one in 10 000 treatments severe complications are seen that warrant special attention.40 ECT therefore is considered to be one of the safest medical procedures under anesthesia.
Cognitive side effects:
All patients are confused on awakening after a seizure. The duration and the severity of the post-seizure delirium vary with patient age (older patients have more severe and more prolonged periods of confusion), dosage and type of anesthetic, and the characteristics of the medications, both psychoactive and systemic, which may be prescribed for the patients. Special attention is paid to sedatives and anxiolytics, antipsychotics, and lithium that may augment the confusional syndrome.
Typical side effects which are more prominent in bilateral than in unilateral and in high-dose than in lower dose ECT4 are transient cognitive disturbances. These include short-term memory disturbances in up to 30% of the treated patients.124 Postictal delirium including a. prolonged reorientation period and memory disturbances including anterograde or retrograde amnesia can be differentiated from rarely occurring effects on the autobiographic long-term memory.125 In addition, cognitive deficits not. emerging from memory disturbances, such as concentration or attention deficits, can occur. It. can be difficult, in an individual patient to differentiate the cognitive side effects of an ECT treatment from cognitive disturbances caused by depression itself.126 Therefore a variety of patients report amelioration of cognitive impairment after an ECT treatment course.127
As described, the rate of cognitive disturbances is dependent, on dose and application of electrical stimulation.85,127 Sometimes patients experience profound and sustained memory loss, sufficient, to interfere with their ability to return to work. Such instances are rare, but. are the principal burden of the complaints against, the use of ECT.2,41
Nevertheless, recent improvements in the use of ECT include methods to maintain good therapeutic efficacy together with a better tolerability concerning cognitive disturbances. Using modified ECT techniques,128 including unilateral or bifrontal pulse wave stimulation, anesthesia with muscle relaxation, and sufficient, oxygenation, these risks could be reduced substantially.64,68,128
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181862/
-
So how many more instances do you have to demonstrate a trend of increased suicide in schizophrenic patients receiving bilateral and/or bifrontal ECT?
1. Electroconvulsive therapy and suicide risk. https://www.ncbi.nlm.nih.gov/pubmed/10073397
2. Death by suicide long after electroconvulsive therapy. Is the sense of coherence test of Antonovsky a predictor of mortality from depression? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253349/
Despite the lack of an acceptable theory as to how it works, Avery and Winokur (46) regard ECT as a suicide preventive, although Fernando and Storm (47) later found no significant difference in suicide rates between patients who received ECT and those who did not. Babigian and Guttmacher (48) found that the mortality risk after ECT was higher soon after hospitalization than in patients who did not receive ECT. Our own study (49) of 30 Irish suicides from 1980 to 1989 showed that 22 patients (73%) had received a mean of 5.6 ECTs in the past. The explanation that "ECT induces a transient form of death and thus perhaps satisfies an unconscious desire on the part of the patient, but this has no preventative effect on suicide; indeed it reinforces suicide in the future." (49) Many psychiatrists today concur that ECT as a suicide preventive does not hold up.
3. https://www.ect.org/resources/abandon.html
PS: Why do you insist in defending ECT for schizophrenia? It is a inhuman treatment which serves no purpose except to prove the pseudoscientific nature of modern psychiatry.
-
"Suicide after unilateral ect in a patient previously responsive to bilateral ect"
Is this how you define "clinical improvement" ?
No smart-ass.... I've already presented the "clinical improvement". You just don't want to accept it.
"47.4 - 72.7% of patients with clozapine-resistant schizophrenia experienced clinical improvement"
(https://az616578.vo.msecnd.net/files/2017/03/18/6362540657520779221824560249_lalala.gif)
~
-
It is a inhuman treatment which serves no purpose
Your opinion has zero merit.
Clinical improvement via ECT in schizophrenia is a scientific fact.
~
-
It is a inhuman treatment
..... Oh hi :)
ECT is one of the best-tolerated biological therapies with low risk for severe complications, even lower than during the application of TC A.2,40 The mortality rate during ECT varies between 1:50 000 and 1:25 000 treatments.2,40 In less than one in 10 000 treatments severe complications are seen that warrant special attention.40 ECT therefore is considered to be one of the safest medical procedures under anesthesia.
-
"Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder"
http://www.pnas.org/content/early/2012/03/12/1117206109.full.pdf+html
"For a long time now, I have been scientifically demonstrating that ECT is a closed-head injury in the form of an electrical lobotomy. Now we find that the ECT damage is sufficiently gross to show up on an MRI — but we are told it’s good for the patients. This is what I call “the brain-disabling principle of psychiatric treatment.” Lobotomy, ECT and psychiatric drugs all share the common factor that they “work” by damaging the brain and suppressing brain function."
http://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1373619.html
lol....
"the rate of cognitive disturbances is dependent, on dose and application of electrical stimulation."
"Typical side effects which are more prominent in bilateral than in unilateral and in high-dose than in lower dose ECT4 are transient cognitive disturbances."
-
I'm interested to understand the rationale of electroconvulsive therapy (ECT) for schizophrenia.
I dont think so. You've made it blatantly clear you don't accept the rationale for ECT in schizophrenia. You can't even understand the significance and/or existence of clinical improvement.... even when it's posted in big bolded excerpts with the corresponding peer-reviewed literature lol.
~
-
Is electroconvulsive therapy for schizophrenia a punitive treatment?
No
It's therapeutic.
Something that can cause permanent brain damage and memory loss is not therapeutic. You seem to forget that psychiatrists should NOT do any harm to their patients, unless they want to violate the hippocratic oath.
That makes about as much sense as saying surgeons shouldn't cut holes in people.
-
You've made it blatantly clear you don't accept the rationale for ECT in schizophrenia.
Congratulations my friend. I didn't knew you were a proponent of eletroshock therapy and torture.
Nice one!
-
^^^^ Like speaking to a wall ^^^^
-
That makes about as much sense as saying surgeons shouldn't cut holes in people.
Thank you.
-
medical procedures under anesthesia
One of the big changes in ECT treatment is that ECT is now given under anesthetic.
In the past it was used without anesthetic, while the patient was conscious. I can see distinct similarities between ECT on a conscious patient and torture.
-
One of the big changes in ECT treatment is that ECT is now given under anesthetic.
In the past it was used without anesthetic, while the patient was conscious. I can see distinct similarities between ECT on a conscious patient and torture.
I guess the option to use anesthetics for ECT is determined by the patient, but the effects are the same on neuronal tissues: The objective of ECT is to always damage brain cells. Most people who received ECT treatment cannot work anymore.
-
medical procedures under anesthesia
One of the big changes in ECT treatment is that ECT is now given under anesthetic.
In the past it was used without anesthetic, while the patient was conscious. I can see distinct similarities between ECT on a conscious patient and torture.
We are discussing [current] therapy here.
-
Most people who received ECT treatment cannot work anymore.
rofl
Do you pull these statements from your behind?
-
Most people who received ECT treatment cannot work anymore.
rofl
Do you pull these statements from your behind?
"In a stunning reversal, an article in the journal Neuropsychopharmacology in January 2007 by prominent researcher Harold Sackeim of Columbia University reveals that electroconvulsive therapy (ECT) causes permanent amnesia and permanent deficits in cognitive abilities, which affect individuals’ ability to function."
http://www.ect.org/?p=699
-
"In a stunning reversal, an article in the journal Neuropsychopharmacology in January 2007 by prominent researcher Harold Sackeim of Columbia University reveals that electroconvulsive therapy (ECT) causes permanent amnesia and permanent deficits in cognitive abilities, which affect individuals’ ability to function."
lol
Am J Psychiatry. 2015 Jan;172(1):52-8. doi: 10.1176/appi.ajp.2014.13060787. Epub 2014 Oct 31.
Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study.
Petrides G1, Malur C, Braga RJ, Bailine SH, Schooler NR, Malhotra AK, Kane JM, Sanghani S, Goldberg TE, John M, Mendelowitz A.
OBJECTIVE:
Up to 70% of patients with treatment-resistant schizophrenia do not respond to clozapine. Pharmacological augmentation to clozapine has been studied with unimpressive results. The authors examined the use of ECT as an augmentation to clozapine for treatment-refractory schizophrenia.
METHOD:
In a randomized single-blind 8-week study, patients with clozapine-resistant schizophrenia were assigned to treatment as usual (clozapine group) or a course of bilateral ECT plus clozapine (ECT plus clozapine group). Nonresponders from the clozapine group received an 8-week open trial of ECT (crossover phase). ECT was performed three times per week for the first 4 weeks and twice weekly for the last 4 weeks. Clozapine dosages remained constant. Response was defined as ≥40% reduction in symptoms based on the psychotic symptom subscale of the Brief Psychiatric Rating Scale, a Clinical Global Impressions (CGI)-severity rating <3, and a CGI-improvement rating ≤2.
RESULTS:
The intent-to-treat sample included 39 participants (ECT plus clozapine group, N=20; clozapine group, N=19). All 19 patients from the clozapine group received ECT in the crossover phase. Fifty percent of the ECT plus clozapine patients met the response criterion. None of the patients in the clozapine group met the criterion. In the crossover phase, response was 47%. There were no discernible differences between groups on global cognition. Two patients required the postponement of an ECT session because of mild confusion.
CONCLUSIONS:
The augmentation of clozapine with ECT is a safe and effective treatment option. Further research is required to determine the persistence of the improvement and the potential need for maintenance treatments.
-
How much money are you getting paid for spreading this pseudoscientific BS?
...
"47.4 - 72.7% of patients with clozapine-resistant schizophrenia experienced clinical improvement"
(https://az616578.vo.msecnd.net/files/2017/03/18/6362540657520779221824560249_lalala.gif)
-
you should ask your girlfriend if she would like an electrochemical lobotomy to clinically improve her mood swings.
lol
That was an excellent comment.
It really added to the integrity of this wonderful thread.
Carry on.
-
You'll love this I guess: http://journals.lww.com/ectjournal/Abstract/2003/03000/Continuation_and_Maintenance_ECT_in.3.aspx
"Despite good results, c/mECT is underused in the treatment of bipolar mood disorder."
-
You'll love this I guess: http://journals.lww.com/ectjournal/Abstract/2003/03000/Continuation_and_Maintenance_ECT_in.3.aspx
"Despite good results, c/mECT is underused in the treatment of bipolar mood disorder."
Yes, I love real evidence as opposed to emotional ranting.
-
exothermic, i would like to apologize to you for my stupid comment.
Take care
tkadm30
-
Is this how you define "clinical improvement" ?
~
-
torture.
-
-
It is a inhuman treatment
(https://68.media.tumblr.com/9894dfae98e3cc2e97a6d791cc618f89/tumblr_nf25i4GLKI1rk0k2jo1_500.gif)