Electroconvulsive Therapy (ECT) - Mothering Forums
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#1 of 22 Old 06-21-2008, 01:36 AM - Thread Starter
 
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I'm looking for information on ECT. Pros, cons, "what your doctor won't tell you" kind of stuff. Does anyone have information they can share? It would be for treating schizoaffective disorder - lots and lots of medications have been prescribed and either have not worked or have only worked minimally. Therapy, hospitalizations, various talk therapies, acupuncture, homeopathy. . .we've tried alot and now the doc is suggesting ECT. Sooooooooo - have you any information to share?
TIA!

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#2 of 22 Old 06-21-2008, 03:36 PM
 
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I don't really have much experience with ECT, but couldn't read and not respond. I know you and DP have been through so much - hopefully you will get all the information you need to make an informed choice.

In my (very, very) limited knowledge of ECT, having seen some patients experience it, it CAN be very effective, esp for the depressive features of the illness. It seems like the psychiatrists that still perform ECT are by and large a very compassionate bunch who are still providing the treatment despite public backlash. That being said, it seems worthwhile to extensively interview these guys and even speak to the nurses that assist. I think they would give the information to you straight.

I'm sure you know about the short-term memory loss. That's the main side effect IIRC. More problematic for some than for others. Hopefully someone else here will be able to give you some first-hand information.
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#3 of 22 Old 06-23-2008, 04:36 PM - Thread Starter
 
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I don't really have much experience with ECT, but couldn't read and not respond. I know you and DP have been through so much - hopefully you will get all the information you need to make an informed choice.

In my (very, very) limited knowledge of ECT, having seen some patients experience it, it CAN be very effective, esp for the depressive features of the illness. It seems like the psychiatrists that still perform ECT are by and large a very compassionate bunch who are still providing the treatment despite public backlash. That being said, it seems worthwhile to extensively interview these guys and even speak to the nurses that assist. I think they would give the information to you straight.

I'm sure you know about the short-term memory loss. That's the main side effect IIRC. More problematic for some than for others. Hopefully someone else here will be able to give you some first-hand information.
Thanks for the response, perl. Yes, there has been a lot for us to deal with and try to figure out. As of yet we have been unable to find information to allow for the informed consent that you are talking about. STM loss is already at a high level due to the illness itself; I can't imagine that it could get worse - that is a scary thought. Thanks again for the response!


And if there is anyone else who has info to share I'd love to hear from you!

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#4 of 22 Old 06-28-2008, 09:04 PM
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Shock therapy??????????

It did nothing for my brother except mess up his memory.

"Our task is not to see the future, but to enable it."
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#5 of 22 Old 06-29-2008, 03:30 AM
 
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It is my understanding that ECT is used for mood disorders (depression in particular that is resistant to other forms of treatment).

I cannot imagine that it would help schizoaffective disorder or any of the thought disorders, and would probably make them worse.

It does cause memory loss (not always on-going but the memories that are lost usually stay lost). Its kind of like they jumble up the brain into a million pieces and hope the pieces fall back down into a better pattern. But sometimes they fall back into a worse pattern.

Is it the affective component of schizoaffective disorder that is most problematic, or the thought disorder component? If its the affective component (mood) then although you've tried all kinds of meds, I think you should keep trying. That part is almost always treatable with meds; you just have to find the right meds. I know its scary and frustrating. ECT might help or it might make things worse.

If its the thought disorder component, well... occasionally some people reach a baseline and they just cannot be helped anymore, and have persistent delusions that are untreatable. The people I know like this aren't particularly distressed; they just make some very odd statements and do some very odd things now and then. Well, hourly. But they're still loveable and likeable, and can function kind of well. ECT won't help and would most likely make things worse in this case.
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#6 of 22 Old 06-30-2008, 01:42 AM - Thread Starter
 
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Thanks so much for your responses It has been really difficult to try and make this decision without being able to have information from people who have kind of seen the treatment in action, so to speak, so any information is helpful.

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Originally Posted by A&A View Post
Shock therapy??????????

It did nothing for my brother except mess up his memory.
Yes, it can also be called shock therapy. And yes, one of the (very unfortunate!) side effects can be memory loss. I'm sorry it did not help your brother. When I am weighing this (memory loss) against the possibility of my child losing a parent to the disease, frankly, memory loss will not be the biggest factor in what I end up deciding about if I am comfortable with it or not. It is a factor for sure, just not the deciding factor.

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It is my understanding that ECT is used for mood disorders (depression in particular that is resistant to other forms of treatment).

I cannot imagine that it would help schizoaffective disorder or any of the thought disorders, and would probably make them worse.
Yes, ECT is sometimes used when there is a depression that is resistant to other treatments. It is also the case when there is treatment-resistant schizophrenia (TRS). Here are a few websites with a little bit of info on research that has been done; unfortunately there are no "case studies" per se.

http://www.cochrane.org/reviews/en/ab000076.html

http://www.ingentaconnect.com/conten...00004/art00013

http://www.schizophrenia.com/sznews/...es/001678.html

http://www.schizophrenia.com/treatments.php#ect


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Originally Posted by BellinghamCrunchie View Post
Is it the affective component of schizoaffective disorder that is most problematic, or the thought disorder component? If its the affective component (mood) then although you've tried all kinds of meds, I think you should keep trying. That part is almost always treatable with meds; you just have to find the right meds. I know its scary and frustrating. ECT might help or it might make things worse.

If its the thought disorder component, well... occasionally some people reach a baseline and they just cannot be helped anymore, and have persistent delusions that are untreatable. The people I know like this aren't particularly distressed; they just make some very odd statements and do some very odd things now and then. Well, hourly. But they're still loveable and likeable, and can function kind of well. ECT won't help and would most likely make things worse in this case.
In truth, neither of these aspects are "worse" than the other so to speak. Yes, there is surely the mood component and there are days she cannot get out of bed, cannot interact with people, has to struggle to get down food and just get through the day. We are not giving up on meds; I guess maybe I didn't make that clear. We are looking for something to complement medications. We know that it will in essence be a miracle if by some chance she does not need to take medication for the rest of her life. Right now we are looking for a way to make the rest of her life happen.
If we are at the baseline for the thought disorder component, well, I don't know how to even think about that. The thought is just so distressing to me (and to her!) - she really is quite frequently just a shell of the person she formerly was. It sounds like maybe the people you know are paranoid schizophrenics? That is not the case here. Yes, she does come up with some weird statements, and do some odd things. But she is VERY distressed. Yes, she is still lovable and likeable. And I want our child to know her himself, not just through stories that people tell him. We have come too close to losing her forever for us to not look at anything presented as a potential treatment.


Reading back through this, it could look like I am upset - and I am - at the disease. I am not at all upset with the responses people have given, so please don't take this as such. I just want to make that clear

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#7 of 22 Old 06-30-2008, 02:26 AM
 
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Just wanted to give you guys a

I know this is hard.
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#8 of 22 Old 06-30-2008, 02:42 AM
 
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It sounds like you have way more knowledge than I do regarding the use of ECT and schizoaffective disorder. I appreciated the links.

The only people I have known who have gone through ECT did it because of extremely resistant depression - depression complicated by personality disorder, which tends to be very challenging to treat because, in my layman's observation, it seems that the depression experienced by PDs is somehow organically different than the depression we think of when we think of mood disorders. Anyway.

It sounds like you all and the doctor think this might be about the only choice left. Maybe she will respond well to it.

Just one last question, not to second-guess you or her doctors or anything but just in case... it sure sounds like the affective component is very painful for her, and probably colors everything so you can't even get a clear picture of the thought disorder part of if. (Actually my experience is more with schizophrenia and schizoaffective - very little with paranoid schizophrenics because they tend to shy away from treatment). Has a medication specifically for mood stabilization (e.g. depakote, tegretol, etc) or depression been combined with an antipsychotic (abilify, geodon, seroquel, etc). Sometimes they prescribe something like zyprexa or seroquel, which can have a mood stabilizing affect but only for mania really and she doesn't sound manic so those meds would only count as antipsychotics not mood stabilizers in her case (hope that made sense). I'm sure you have probably tried this. But I have seen pretty good results when depakote is combined with an antipsychotic for schizoaffective, for example. Some elements of the thought disorder remain but its such a huge difference when a person is able to be calm and happy much of the time, even if they still have odd notions about their place in the world or why they are the way they are, or hear voices.
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#9 of 22 Old 06-30-2008, 04:00 AM - Thread Starter
 
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Just wanted to give you guys a

I know this is hard.
This is very hard. I would not wish it on anyone. Thank you so much for the hug

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#10 of 22 Old 06-30-2008, 04:16 AM - Thread Starter
 
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for some reason MDC won't let me quote more than one post right now. Strange

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Originally Posted by BellinghamCrunchie View Post
It sounds like you have way more knowledge than I do regarding the use of ECT and schizoaffective disorder. I appreciated the links.

The only people I have known who have gone through ECT did it because of extremely resistant depression - depression complicated by personality disorder, which tends to be very challenging to treat because, in my layman's observation, it seems that the depression experienced by PDs is somehow organically different than the depression we think of when we think of mood disorders. Anyway.

It sounds like you all and the doctor think this might be about the only choice left. Maybe she will respond well to it.

Just one last question, not to second-guess you or her doctors or anything but just in case... it sure sounds like the affective component is very painful for her, and probably colors everything so you can't even get a clear picture of the thought disorder part of if. (Actually my experience is more with schizophrenia and schizoaffective - very little with paranoid schizophrenics because they tend to shy away from treatment). Has a medication specifically for mood stabilization (e.g. depakote, tegretol, etc) or depression been combined with an antipsychotic (abilify, geodon, seroquel, etc). Sometimes they prescribe something like zyprexa or seroquel, which can have a mood stabilizing affect but only for mania really and she doesn't sound manic so those meds would only count as antipsychotics not mood stabilizers in her case (hope that made sense). I'm sure you have probably tried this. But I have seen pretty good results when depakote is combined with an antipsychotic for schizoaffective, for example. Some elements of the thought disorder remain but its such a huge difference when a person is able to be calm and happy much of the time, even if they still have odd notions about their place in the world or why they are the way they are, or hear voices.
The little that I know about the disorder I have learned of necessity, believe me. You'd be amazed how many people in the field we have come in contact with that don't know much at all about schizoaffective disorder. We have had to print off articles and bring them to appointments, but I digress. I hope that the links helped explain the rationale for the treatment better than I can.

Didn't think you were second guessing
Yes, the mood/affective component does (to the outside observer especially) seem more manifested in this case. We are able to get most of our information about the thought disorder part when she is in a better place and able to communicate (duh, sorry I am tired - it is after midnight right now). Yes, she has been on both antidepressants and antipsychotics at the same time. There are also times of mania when there is virtually no sleep for two weeks at a time - operating on no more than an hour or two of sleep in a 24 hour period. So right now the med concoction includes (among others) zyprexa, abilify, lamictal, ambien, seroquel, and I think at least one other, but I am too tired to go look it up. It looks like a pretty strong cocktail, but unfortunately it is not strong enough. I would be ecstatic if she could be calm and happy most of the time.

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#11 of 22 Old 06-30-2008, 04:30 PM
 
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Sussanah,

My heart goes out to you and your family!

DF has Parkinsons disease and was treated with ECT for severe depression about 10 years ago. (His form of Parkinsons not only affects his motor-skills but seems to have a great psychiatric component).
The first round was great! He really snapped back to his old self for a while (maybe 1yr+).
Then he had to have another round and that had to be stopped because he could recall (word-for-word) what everyone had said while he was under anasthesia. This is probably a strange side-effect from the Parkinsons...
While he was undergoing ECT, he stayed in a locked ward at a local hospital. Many of the patients seemed to respond quite well.

About 2 years ago, DF decided that more meds (dopamine) helped him move better and be able to do more things. He overdosed himself and was acting like a paranoid scizophrenic. Just an FYI that many of the meds can have affects if they are not exactly right (whether it's the person taking them or the doc prescribing them).
Hope you find some positive results soon! :
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#12 of 22 Old 06-30-2008, 05:23 PM - Thread Starter
 
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Sussanah,

My heart goes out to you and your family!

DF has Parkinsons disease and was treated with ECT for severe depression about 10 years ago. (His form of Parkinsons not only affects his motor-skills but seems to have a great psychiatric component).
The first round was great! He really snapped back to his old self for a while (maybe 1yr+).
Then he had to have another round and that had to be stopped because he could recall (word-for-word) what everyone had said while he was under anasthesia. This is probably a strange side-effect from the Parkinsons...
While he was undergoing ECT, he stayed in a locked ward at a local hospital. Many of the patients seemed to respond quite well.

About 2 years ago, DF decided that more meds (dopamine) helped him move better and be able to do more things. He overdosed himself and was acting like a paranoid scizophrenic. Just an FYI that many of the meds can have affects if they are not exactly right (whether it's the person taking them or the doc prescribing them).
Hope you find some positive results soon! :
Thanks for the response. Wow, I didn't know that ECT was used for Parkinsons at all! It is really good to hear that the first round worked for him. I wonder why he needed to stay in a locked ward during the treatment and if that is common procedure. It is anything that was mentioned by the doc, but it wouldn't necessarily surprise me if she just didn't disclose that information. Yeah, we have seen a number of medications that create really bad side effects for her, so that is why she has tried so many.
Thanks for the info

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#13 of 22 Old 07-02-2008, 10:35 PM
 
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I've read some great things about ECT. It's so much more fine tuned now than "shock therapy". It can sometimes be miraculous for parkinsons and other tremor disorders. I guess I would see it as a last resort, and probably try other things first. And I would go to the best of the best. You are talking about disordered brain waves, though, so I think there's a good chance it can help if done perfectly.

Has the person in your life struggling with this been tested for Pyroluria? It's of course controversial, but in the Mood Cure, Julia Ross says that at least 40% of individuals with schizophrenia or schizoaffective disorder have this. And the treatment is zinc and b-vitamins. It's very easy to test for as well, you can do it at home with a liquid zinc supplement. Your health food store would know which one, it's used to test for zinc deficiency.
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#14 of 22 Old 07-03-2008, 04:15 AM - Thread Starter
 
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I've read some great things about ECT. It's so much more fine tuned now than "shock therapy". It can sometimes be miraculous for parkinsons and other tremor disorders. I guess I would see it as a last resort, and probably try other things first. And I would go to the best of the best. You are talking about disordered brain waves, though, so I think there's a good chance it can help if done perfectly.

Has the person in your life struggling with this been tested for Pyroluria? It's of course controversial, but in the Mood Cure, Julia Ross says that at least 40% of individuals with schizophrenia or schizoaffective disorder have this. And the treatment is zinc and b-vitamins. It's very easy to test for as well, you can do it at home with a liquid zinc supplement. Your health food store would know which one, it's used to test for zinc deficiency.

Wow. I've never heard of pyroluria, but it looks very similar based on what I found by googling. We'll have to see what we can find out about this. Hmmm. Thanks so much :

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#15 of 22 Old 07-03-2008, 03:43 PM
 
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I really believe a lot of mental illness has to do with what our bodies are missing due to bad diets, bad habits, etc. Which is not to say it's our fault, but that our society is just plain living the wrong way.

Good luck, I do hope it's pyroluria, because that is so much easier to overcome that schizoaffective disorder, which is considered a life-long diagnosis, so once you have it, good luck getting rid of it!!
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#16 of 22 Old 07-03-2008, 06:10 PM - Thread Starter
 
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Good luck, I do hope it's pyroluria, because that is so much easier to overcome that schizoaffective disorder, which is considered a life-long diagnosis, so once you have it, good luck getting rid of it!!
No kidding. Thanks

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#17 of 22 Old 07-03-2008, 06:58 PM
 
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I had ECT recently.

I was diagnosed with psychotic depression and committed. I had 2 forced sessions a week for 6 weeks.

It, along with medications certainly lifted my psychosis and depression, it is hard to say which helped the most.

Due to being ill, I fought each treatment and 5 people pinned me down n the bed until they put the needle in my hand that sent me to sleep. They were all very caring people though I have to say.

Minutes later I would be in the recovery room and often be very disorientated. This would wear off after a while, but my short term memory was wiped. I had people visit me in hospital and I cannot remember. I would often ask my sister to remind me of things when I came round.

I hope you find something that works xxxxxx

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#18 of 22 Old 07-03-2008, 07:12 PM - Thread Starter
 
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I had ECT recently.

I was diagnosed with psychotic depression and committed. I had 2 forced sessions a week for 6 weeks.

It, along with medications certainly lifted my psychosis and depression, it is hard to say which helped the most.

Due to being ill, I fought each treatment and 5 people pinned me down n the bed until they put the needle in my hand that sent me to sleep. They were all very caring people though I have to say.

Minutes later I would be in the recovery room and often be very disorientated. This would wear off after a while, but my short term memory was wiped. I had people visit me in hospital and I cannot remember. I would often ask my sister to remind me of things when I came round.

I hope you find something that works xxxxxx
First of all, thank you so much for responding! I truly appreciate it :
I am so glad that it has helped you, but I would imagine that it would have been traumatic to have received it by force.
I have a few questions for you if you wouldn't mind answering them
1 - Do you know how long you were asleep from the medication?
2 - Did they allow anyone you know to go in the room with you?
3 - About how long were you disoriented? Were you allowed to have a loved one in the recover room?
4 - How long do you think the treatment affected your short term memory?
5 - Do you know if they would have done the ECT as out patient therapy if you had not already been in the hospital?
Thanks so much again for your response

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#19 of 22 Old 07-03-2008, 10:46 PM
 
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I had ECT recently.

I was diagnosed with psychotic depression and committed. I had 2 forced sessions a week for 6 weeks.

Minutes later I would be in the recovery room and often be very disorientated. This would wear off after a while, but my short term memory was wiped. I had people visit me in hospital and I cannot remember. I would often ask my sister to remind me of things when I came round.

I hope you find something that works xxxxxx
Just so you know, the short term memory loss could also be due to the psychosis. My DH doesn't remember some of his more severe psychotic moments. Hugs in any case.
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#20 of 22 Old 07-04-2008, 01:35 AM - Thread Starter
 
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Just so you know, the short term memory loss could also be due to the psychosis. My DH doesn't remember some of his more severe psychotic moments. Hugs in any case.
You know, I didn't think about that, but the same thing is true for my DP.

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#21 of 22 Old 07-04-2008, 06:55 PM
 
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First of all, thank you so much for responding! I truly appreciate it :
I am so glad that it has helped you, but I would imagine that it would have been traumatic to have received it by force.
I have a few questions for you if you wouldn't mind answering them
1 - Do you know how long you were asleep from the medication?
2 - Did they allow anyone you know to go in the room with you?
3 - About how long were you disoriented? Were you allowed to have a loved one in the recover room?
4 - How long do you think the treatment affected your short term memory?
5 - Do you know if they would have done the ECT as out patient therapy if you had not already been in the hospital?
Thanks so much again for your response

1- I never really timed it, was too ill, but I think it was only 5-10 minutes or so that I was asleep for. I was all done and dusted well within an hour back to the ward.

2-There was only ever a nurse who escorted me into the procedure room, though I see no reason why a loved one could not be there until you went to sleep.

3- I was only disorientated on waking and probably the next 5 minutes, then I became aware of where I was and what had happened. I never had my husband with me as he was never there when they did the ECT and I can't remember but I have a feeling other people did have their loved ones with them in the recovery room.

4- The short term memory loss seemed very much what had happened the few hours previously. I guess some of the memory loss could well be due to the psychosis as I can't remember events leading up to me being admitted. But I do know I forgot conversations I had just an hour before the ECT which is why I would tell my sister things I wanted to remember so she would tell me when I got back.

5- All the other people who were there for ECT were out-patients.

I hope this helps, I just wish I could remember more for you :

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#22 of 22 Old 07-04-2008, 09:46 PM - Thread Starter
 
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I hope this helps, I just wish I could remember more for you :
Thank you, thank you, thank you :

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