Neuromodulaton Therapy

What is ECT treatment?

ECT is a medical treatment known to be effective for many mental disorders and certain serious medical conditions. After general anaesthesia, an electrical current is delivered into the skull through electrodes for a few seconds. This current induces a short brain seizure but does not cause any pain.

What conditions can ECT be used for?
  • ECT is most commonly used for depression.
  • Catatonia – an uncommon condition in which a patient may stop talking, eating or moving.
  • Manic phase of bipolar disorder.
  • ECT can help symptoms of schizophrenia which has not improved with medication.
  • ECT is not advised for the treatment of anxiety or most other psychiatric conditions
When might your doctor suggest ECT?

It Will Usually Be Suggested If Your Condition Is:

  • Life-threatening and rapid improvement is needed to save your life
  • Either causing you immense suffering or is likely to get worse, so that a rapid improvement is needed
  • Not responded to other treatments, such as medication and psychological therapy
  • Responded well to ECT in the past.
How effective is ECT?

Most people who have ECT see an improvement in their symptoms.

How does ECT work?

The effects of ECT gradually build with each treatment. It causes the release of certain brain chemicals. These seem to stimulate the growth of some areas in the brain that tend to shrink with depression. ECT also appears to change how parts of the brain which are involved in emotions interact with each other.

Are there different types of ECT?

There Are Two Ways In Which Ect Is Given: ‘Bilateral’ And ‘Unilateral’.

  • In bilateral ECT, the current passes across your head, between your temples.
  • In unilateral ECT, it passes between your right temple and the top of your head
Can ECT be used for children or young people?
  • ECT is not used for children under the age of 11.
  • It should only be used in a young person aged 11 to 18 as a treatment of last resort – if their illness is life threatening or is severe and has not responded to other treatments.
What happens when you have ECT?
  • ECT is given in hospital either as inpatient or as day care in the ECT room.
  • As a day patient, a named, responsible, adult will have to accompany you to and from the ECT clinic.
  • Qualified staff will look after you all the time while you are there. They will help you with the process of waking up from the anesthesia.

Preparing for ECT

In the days before your course of ECT is started, your doctor will arrange for some tests to make sure it is safe for you to have a general anesthesia. These may include:

A record of your heartbeat (ECG)
Blood tests
A chest X-ray.
How often and how many times is ECT given?
  • Usually, twice per week
  • On average, the total number of sessions needed is 9-10, although it is common to have 12 treatments and more may sometimes be needed.
  • ‘Maintenance’ ECT is occasionally used to help stop you becoming unwell again after a successful course of treatment. It is given less often but over a longer period of time than the first course.
What happens after a course of ECT?

ECT is one part of getting better. Medication will be continued after ECT.

What are the side effects of ECT?

Side Effects Are Usually Mild And Short Term.

Short-Term Side Effects

Immediately After An Ect Treatment, You May Feel:

  • Headache
  • Aching in the muscles and/or jaw.
  • Tiredness while the effects of the anesthetic wear off.
  • Confusion, particularly in elderly
  • Nausea
  • Temporary memory problem

Rigorous scientific research has not found any evidence of physical brain damage to patients who have had ECT. There is no increased risk of epilepsy, stroke or dementia after ECT

What Are The Contraindications?
  • Specific neurological conditions (e.g.: intracranial hypertension)
  • Certain heart conditions (e.g.: recent myocardial infarction)
  • Allergies (e.g., drugs for anesthesia)

Due to these conditions, the decision to use this therapy is made after a complete physical exam. ECT is given in a treatment room equipped to solve any problems that may arise

Is ECT consent mandatory?

Yes. Before receiving treatment, users (or their representative) must provide written consent to authorize ECT and general anesthesia by signing a consent form. The consent must be free (without coercion or pressure) and informed (in the light of all the information). It is a good idea for the user to be accompanied by a relative or anyone who can help him make a decision.

What is rTMS?

Repetitive Transcranial Magnetic Stimulation (rTMS) uses pulsing magnetic fields to activate or suppress the brain centres associated with medical and psychiatric disorders, thus treating the brain circuits involved in your condition. Treatment is non-invasive and is usually given as an outpatient, generally alongside medication.

How does rTMS work?

rTMS uses a focused electromagnetic field to stimulate certain areas of your brain. These areas affect your impulses, thoughts, emotions and behaviours, and maybe more or less active in people with depression and other mental health disorders.

The doctor or rTMS technician stimulates the brain by placing a magnetic coil against your scalp in a specific area. The coil delivers magnetic pulses to the brain. Research shows that a full course of rTMS can help the brain return to normal functioning

Who can have rTMS?

Patients who have not responded to medications or psychological therapy (treatment resistance)

  • severe depression
  • Obsessive-compulsive disorder (OCD)
  • Anxiety
  • It is also being studied for use in other mental health conditions such as
    • Bipolar affective disorder
    • Generalized anxiety disorder
    • Post-traumatic stress disorder (PTSD)
    • Substance use disorders
    • Eating disorders (anorexia and bulimia nervosa)
    • Psychotic disorders
    • Autism spectrum illness
Who can’t have rTMS?

Given The High Magnetic Fields Needed, You Are Unable To Receive Rtms Treatment If You Have Any Type Of Non-Removable Metal In Or Near Your Head, Except For Braces Or Dental Fillings. Therefore, People Who Have Any Of The Following Should Not Receive Rtms:

  • Aneurysm clips or coils
  • Stents in the neck or brain
  • Deep brain stimulators
  • Electrodes to monitor brain activity
  • Metallic implants in your ears and eyes
  • Metal shards, shrapnel or bullet fragments in or near the head
  • Facial tattoos with metallic or magnetic-sensitive ink (please discuss with us if in you are unsure)
  • Other metal devices or object implanted in or near the head
What does rTMS involve?

Treatment with rTMS usually involves daily sessions of up to 30 minutes (but often less than 10 minutes), five days a week, for four to six weeks.

What are the possible side effects?

Common side effects

  • Scalp pain during treatment (feels like static electricity and gets better after the first few sessions
  • Headaches
  • Fatigue (feeling tired) after treatment