West Australian
Wednesday 8/01/2014
Page:
Section:
Region:
Circulation:
Type:
Size:
1
Health
Perth, AU
178385
Capital City Daily
893.16 sq.cms.
press clip
SHOCK TACTICS
While electroconvulsive therapy is credited with saving the lives of patients
with severe depression, the stigma around this treatment remains
By Marnie McKimmie
Page 1 of 3
Copyright Agency Limited (CAL) licenced copy
AUS: 1300 1 SLICE NZ: 0800 1 SLICE
[email protected]
Ref: 231149747
West Australian
Wednesday 8/01/2014
Page:
Section:
Region:
Circulation:
Type:
Size:
1
Health
Perth, AU
178385
Capital City Daily
893.16 sq.cms.
press clip
ven after 80 years of use,
electroconvulsive therapy (ECT) still
carries an enormous stigma.
Hollywood Clinic psychiatrist Andrew
Jackson said effort was needed to
overcome community fear about the procedure.
It continues to save local lives and prevent
hospitalisation in a small group of patients with
severe treatment-resistant depression and
suicidal tendencies.
While ECT use over recent decades had been
finetuned and significantly scaled back because
of the greater availability of psychiatric drugs, Dr
Jackson said it was still required to treat one
million patients around the world annually who
failed to respond to medication, counselling and
therapy. This included an average of six patients
a week undergoing ECT sessions at Hollywood
Private Hospital.
For such patients, depression could be so
severe they were unable to get out of bed and
lost interest in eating and drinking to the point
that it became life-threatening.
Dr Jackson said the stigma surrounding ECT
continued to be a barrier to treatment and had
resulted in ECT being left behind while
significant gains had been made in
destigmatising other sectors of mental health
care. Partly to blame, he said, were
sensationalised and factually incorrect portrayals
of ECT in films and the media.
E
‘We see dramatic and wonderful
responses and lives turned around. One
patient of mine who had been requiring
multiple admissions to hospital every
year has had a dramatic response to the
ECT and really has not been back to
hospital for the past four years.’
ANDREW JACKSON
CTICS
es of patients
His concern was this might prevent people
considering ECT, which involved the delivery of
an electrical current to induce a seizure for
therapeutic purposes.
“I have certainly seen cases where ECT has
literally been lifesaving,” Dr Jackson said.
“Although it is used less often now than in the
past, it is still a very important treatment.
“We see dramatic and wonderful responses
and lives turned around. One patient of mine
who had been requiring multiple admissions to
hospital every year has had a dramatic response
to the ECT and really has not been back to
hospital for the past four years.
“It is a shame that there is such a stigma about
it. I think ECT should be approached
Continued page 2 ៑
Page 2 of 3
Copyright Agency Limited (CAL) licenced copy
AUS: 1300 1 SLICE NZ: 0800 1 SLICE
[email protected]
Ref: 231149747
West Australian
Wednesday 8/01/2014
Page:
Section:
Region:
Circulation:
Type:
Size:
1
Health
Perth, AU
178385
Capital City Daily
893.16 sq.cms.
press clip
្ From page 1
fundamentally in the way that any
other medical treatment is. There
should be an objective assessment of
the possible benefits, of the risks and
the side effects. They all need to be
weighed up and evaluated.”
With use tightly controlled and
regulated by the WA Health
Department and the Office of the
Chief Psychiatrist, ECT involves
delivering, under the direction of a
psychiatrist, a brief electrical charge
of about five seconds to the brain
through the skull, that triggers a
short seizure of about 20 seconds.
Often done as an outpatient
procedure, general anaesthetic and
muscle relaxants are administered by
an anaesthetist. It is usually offered
as a 12-treatment program over the
course of four weeks.
ECT was first developed in the
1930s after it was observed that
some patients with mental illness and
epilepsy improved temporarily if they
had had a seizure. Back then, due to
the fewer treatment options
available, ECT was initially used for a
wide range of mental health
conditions before being scaled back,
better targeted for effectiveness, and
finetuned, which dramatically reduced
complications and side effects.
While research to date had focused
on the safety and effectiveness of
ECT, Dr Jackson said studies were still
being conducted to pinpoint the exact
mechanism triggered in the brain that
led to positive outcomes in patients.
“Some of the theories are that ECT
increases the number of
neurotransmitters that are in the
brain and that it results in some
changes in blood flow and
metabolism in parts of the brain,” he
said.
“More recently there has been
some evidence that it increases the
production of brain-derived
neurotrophic growth factor, which is
an important hormone for regulating
the health of the nerve cells in the
brain.”
The Royal Australian and New
Zealand College of Psychiatrists states
in its position statement that ECT is a
highly effective treatment with a
strong evidence base, particularly for
the treatment of severe depressive
disorders.
WHAT IS IT? ECT involves the delivery of an electrical current to
induce a seizure for therapeutic purposes, reports the Royal
Australian and New Zealand College of Psychiatrists
(www.ranzcp.org). Before the procedure, a medication which causes
muscle relaxation (prevents muscles from contracting) is
administered with a general anaesthetic so there is minimal physical
movement during the seizure. The patient is anaesthetised and
awakes several minutes after the procedure is completed.
TIME TAKEN About five seconds for the charge and overall 30
minutes for the treatment. It can be done as an outpatient, often
offered as a 12-treatment program over the course of four weeks.
SAFETY AND SIDE EFFECTS ECT is regarded as a very safe
treatment, with no evidence of long-term damage to brain functions,
such as reasoning and creativity, reports SANE Australia, the national
mental health charity. A headache and confusion may be
experienced for 30 minutes after the procedure, according to
Hollywood Clinic psychiatrist Andrew Jackson. Short-term
memory-loss is also a common side effect, however memory usually
quickly returns to normal.
Psychiatrist Andrew
Jackson with the ECT machine
at Hollywood Private Hospital.
Picture: Kate Ferguson
Page 3 of 3
Copyright Agency Limited (CAL) licenced copy
AUS: 1300 1 SLICE NZ: 0800 1 SLICE
Electroconvulsive therapy (ECT)
[email protected]
Ref: 231149747