전기경련요법의 실제적 측면

The Practical Aspects of Electroconvulsive Therapy

Today two kinds o f biological treatments, i.e., the pharmacological treatment and electroconvulsive treatment (ECT), are commonly utilized among various biological treatments in psychiatric fields. A lthough many kinds o f biological treatments have disappeared after the advent o f psychopharmacological treatments, ECT remains clinically relevant because o f its clinical efficacy, safety and utility. ECT is indicated in patients with major depressive disorder, schizophrenia, manic episode and other serious mental disorders as a safe and effective treatment. It has been well known that the therapeutic effects o f antipsychotics and mood stabilizing drugs appear after two-week trial. In contrast the efficacy o f ECT appear within two or three treatments. ECT is superior to tricyclic antidepressant in the treatment o f major depressive disorders and at least equal to and perhaps superior to lithium in the treatment o f acute manic episodes. Schizophrenic patients with marked positive symptoms, catatonia, or affective symptoms are thought to be most likely to respond to ECT. The efficacy o f ECT in such patients is about equal to that o f antipsychotics. Many clinicians and researchers believe that ECT is grossly underused as a treatment. Clinicians should evaluate their patients and not be reluctant to apply ECT.