Recent Trends for Optimization of Electroconvulsive Therapy

Tak Youn; Ung Gu Kang; Yong Sik Kim; In Won Chung

doi:10.4306/jknpa.2016.55.1.12

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Youn, Kang, Kim, and Chung: Recent Trends for Optimization of Electroconvulsive Therapy

Review Article

Journal of Korean Neuropsychiatric Association 2016; 55(1): 12-24.

Published online: 29 February 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.1.12

Recent Trends for Optimization of Electroconvulsive Therapy

Tak Youn, MD^1,², Ung Gu Kang, MD³, Yong Sik Kim, MD^1,², In Won Chung, MD^1,²

¹Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Korea.

²Institute of Clinical Psychopharmacology, Dongguk University College of Medicine, Goyang, Korea.

³Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

Address for correspondence: In Won Chung, MD Department of Psychiatry, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea. Tel +82-31-961-7239, Fax +82-31-961-7236, ciw@duih.org

Received 28 December 2015 Revised 3 February 2016 Accepted 4 February 2016

Abstract

Electroconvulsive therapy (ECT) is a safe and effective treatment not only for various mental disorders including depression, mania, and schizophrenia, but also for inadequacy and resistance to pharmacotherapy and the psychiatric emergences. The historical ups and downs of ECT treatment since its first introduction in 1938 were ended by the validation impacts of evidence-based medicine in the 1980s and by other clinical issues. Clinical research for the optimization of ECT to maximize therapeutic effects and to minimize adverse effects is ongoing to establish standardized procedures and educational programs through the ECT center. In addition, guidelines for ECT practices are also being developed for the clinical excellence of ECT practices in accordance with the recommendations of international organizations such as World Psychiatric Association and American Psychiatric Association. This article was prepared by reviews of the literature, direct observations of ECT practices abroad, and interviews with ECT experts around the world in order to enhance therapeutic effects with recently updated ECT practices under the belief that the most appropriate treatments should be provided to the patients in need.

Keywords: Electroconvulsive therapy, Optimization, Biological treatment

Figures and Tables

Table 1

ECT dosage table in bilateral electrode setting

The dosage table is modified from the dosage table in ECT center of University of Pittsburgh Medical Center. The values of parameters in bilateral 50% and 150% are calculated from titration parameters in left panel. PW : Pulse width, FREQ : Frequency, DUR : Duration, Amp : Ampere, mC : mCoulomb, ECT : Electroconvulsive therapy

Table 2

ECT dosage table in unilateral electrode setting

The dosage table is modified from the dosage table in ECT center of University of Pittsburgh Medical Center. The values of parameters in RUL 500% are calculated from titration parameters in left panel. PW : Pulse width, FREQ : Frequency, DUR : Duration, Amp : Ampere, mC : mCoulomb, ECT : Electroconvulsive therapy, RUL : Right unilateral

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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