Electroconvulsive therapy not useful on except:
Ans: C (Depression) Ref: Synopsis of Psychiatry, Kaplan & Sadock, 10th editionExplanation:Electro-Convulsive Therapy It is one of the physical methods of treatment in psychiatry.Psychosurgery, Vagal Nerve Stimulation , Repetitive Transcranial Magnetic Stimulation , Deep Brain Stimulation are other physical methods.ECT is very effective in treating:Severe depression with suicidalityCatatoniaMania/ExcitementOCD (intractable cases)The exact mechanism of action of ECT is not known but it has been hypothesized that direct stimulation of neurons by current and / or activation of HPA axis / HPT axis or enhancement of certain neurotransmitters like serotonin are proposed.Whatever the mechanism. ECT is not only effective but also rapid in its effect (drugs might take days and psychotherapy might take months to show efficacy) and safe also.Contraindications:1. Absolute contraindicationRaised intracranial pressure (the ONLY absolute contraindication) as evidenced by papilledema clinically.2. Relative contraindications (which means, the following conditions should be treated adequately and patient should be fit) - Hypertension. Diabetes. Sepsis, etc.Types of ECT:1. Unmodified (No anaesthesia).2. Modified (under general anaesthesia) .Drugs Used in ECT:1. IV anaesthetic agents like methohexiatone. thiopentone sodium and propofal2. Muscle relax ants like succinyleholine3. Anti-secretary agents like atrophine. gly copyrrol ateSide Effects of ECT:Transient deliriumHeadacheNauseaBody achesReversible memory loss (both retrograde and anterograde)
Delirium
Seizures
Depression
Panic attacks
Psychoanalysis and Psychotherapy