Is Shock Therapy Returning for Bipolar Disorder?

FRIDAY September 25, 2020 (HealthDay News) – Over the years, electroconvulsive therapy (ECT) – commonly referred to as “shock therapy” – has had a bad reputation.

But new research in Italy suggests the reputation may not be justified. Researchers have found that among bipolar patients who do not respond to standard treatments, ECT can be a lifesaver, preventing uncontrollable mood swings and dramatically reducing the risk of suicide.

The study – among the largest of its kind – followed 670 Italian adults who underwent electrosurgery for bipolar disorder at a single psychiatric clinic between 2006 and 2019.

“Importantly, 84% of patients at high risk of suicide before ECT were no longer considered openly suicidal after treatment,” said senior author Dr Giulio Brancati, resident in clinical and experimental medicine at the University. from Pisa.

“Overall, 72% of patients showed a good response to ECT,” added Brancati.

For about six in 10 people, ECT appeared to relieve a range of debilitating symptoms – including delusions, aggression, lack of cooperation, emotional hypersensitivity, physical hyperactivity, and paranoia. Depression and anxiety were alleviated in just over a quarter of patients.

Based on the results, Brancati said that “ECT should be seen as a valuable treatment for severe episodic syndromes”, especially the kind of over-excitement, agitation, hostility and mistrust that can occur. when manic, depressive and psychotic symptoms intertwine.

The study team noted that bipolar disorder affects around 1% of the population. It can manifest as fits of mania and depression, leading to a deep sense of guilt and worthlessness, and an increased risk of suicide.

About two-thirds of patients respond well to prescription drugs, including mood stabilizers and antipsychotics. The rest no.

Enter ECT. Launched in Rome in 1938 by Lucio Bini, psychiatrist, and Ugo Cerletti, neurologist, it quickly spread around the world. It works by generating a short-lived electrical crisis in the brain and is typically given two to three times per week as part of a six to 12 session regimen.

Brancati admitted his bad reputation was not unfounded.

“It is not wrong that ECT has sometimes been administered in a non-therapeutic, even abusive manner,” he said. For example, Brancati noted that early ECT patients were not medicated during treatment, “which often led to serious musculoskeletal complications.”

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Jothi Venkat

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