전기경련요법의 작용기전

Action Mechanisms of Electroconvulsive Therapy

Electroconvulsive therapy which has not only antidepressant effects but also antipsychotic, antimanic and anticonvulsant effects exerts it’s effects via changes on electrical, biochemical, endocrinological, vessels and cell membranes in the brain. And the influences to the biogenic amine system which is thought to be the powerful theoretical mechanism o f endogenous depression seems to be closely related with the antidepressant effects o f the ECT. Findings which is consistent are resensitization o f the beta-adrenergic receptors, up-regulation o f the 5-HT receptors and up-regulation o f the GABA-B receptors. The rapid neurobiological changes after the ECT would be nonspecific and rather be due to ECT induced convulsion itself. When the ECT applied repeatedly, the biological responses seem to be delayed. It is thought that the changes are influenced by the readjustment o f the sensitization on pre-and post-synapses and o f the dynamic imbalance in various types o f neurotransmitters. Despite considerable investigation, until recently we only know cut edge o f the brain function. The knowledges derived from the study o f ECT could give better understanding o f the pathogenesis o f depression and permit more effective psychopharmacological treatment modalities