Abstract
Electroconvulsive therapy (ECT) is the most effective treatment available for severe depression, with a remission rate of 60%. It is a safe procedure and the major medical risks are related to anaesthesia (mortality 1:80,000). Early use of ECT is associated with shorter and less costly hospital stays and it is reported to enhance health-related quality of life and activities of daily living. Bilateral ECT is more powerful than unilateral ECT but is associated with more cognitive side-effects. The precise mechanism of action of ECT is not yet known, but in animal models it up-regulates neurotrophic factors and induces hippocampal neurogenesis. No convincingly useful antidepressant effect has yet been demonstrated for transcranial magnetic stimulation (TMS) or vagus nerve stimulation (VNS), and these methods, along with deep brain stimulation (DBS) are best considered for research purposes only. Stereotactic neurosurgery for mental illness is practised only in specialized centres for intractable illness, but has a good outcome.
| Original language | Undefined |
|---|---|
| Pages (from-to) | 499-500 |
| Number of pages | 2 |
| Journal | Medicine |
| Volume | 36 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 1 Sept 2008 |
Keywords
- Electroconvulsive therapy
- Depressive disorder
- hippocampus
- neurosurgery
- Transcranial magnetic stimulation