The Electroconvulsive Therapy Workbook Clinical Applications

Electroconvulsive Therapy (ECT) remains one of the most effective forms of neurostimulation for severe mental illness. Sound scientific research underpins contemporary practice challenging the complex history and stigma that surround this treatment. The Electroconvulsive Therapy Workbook integrates the history of ECT with major advances in practice, including ultrabrief ECT, in a hands-on workbook format. Novel forms of neurostimulation are reviewed, highlighting the future directions of practice in this exciting area. The book is also richly illustrated with historical and technical images and includes ‘clinical wisdom’ sections that provide the reader with clinical insights into ECT practice. Online eResources are also available, featuring a wide range of questions and answers related to each chapter to help test and consolidate readers’ understanding of ECT, as well as regionally specific legislation governing ECT practice in Australia and New Zealand. This comprehensive introduction to ECT is a must-read for doctors in training, psychiatrists who require credentialing in this procedure, anaesthetists, nursing staff who work in ECT and other professionals who have an interest in ECT as well as consumer and carer networks.

1. Introduction 1.1 Overview 1.2 Definition 1.3 Equipment 2. Knowledge 2.1 History: Treatment of Mental Illness 2.2 History:ECT 2.3 Major Advances in ECT Practice 2.4 Mechanism of Action 2.5 Clinical Indications for ECT: Adults 2.6 Clinical Indications for ECT: Children and Adolescents 2.7 Clinical Indications for ECT: Older People 2.8 Efficacy of ECT 2.9 Contraindications for ECT 2.10 Brain Stimulation / New Directions 3. Organisational / Administrative Skills 3.1 Setting Up an ECT Service / Clinical Governance 4. Clinical Skills 4.1 The Sequence of ECT 4.2 Adverse Events of ECT 4.3 Medical Risks and Management 4.4 Drug Interactions 4.5 Tips for Clinical Practice 5. Technical Skills 5.1 ECT Technique 5.2 Electrode placement 5.3 Stimulus Dosing Strategies 5.4 The Stimulus 5.5 The Electroencephalogram (EEG) 5.6 Anaesthesia for ECT 5.7 ECT Devices: Set up Procedure 6. Ambulatory ECT, Continuation and Maintenance ECT 7. ECT Nurse and the ECT Coordinator 8. ECT: The Lived Experience 8.1 Consumer Perspectives: Wow I Have My Life Back! By Alirra 9. Scenario-Based Problems 9.1 Post-Ictal Delirium and ECT 9.2 ECT, The Elderly and a High Seizure Threshold 9.3 ECT, Epilepsy and Obsessional Personality Style 9.4 Fear of ECT 9.5 Complex ECT Treatments 9.6 EEG Challenges: What should you do next?

Alan Weiss is conjoint senior lecturer at the University of Newcastle, Australia. He is also a fellow of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and chair of the Colleges Section for ECT and Neurostimulation (SEN); clinical director of the neurostimulation programme for the Hunter New England Local Health District; chair of the expert committee to revise 2010 NSW ECT Guidelines; and foundation director of neurostimulation at two private hospitals in Newcastle. Dr Weiss is a member of the International Society for ECT and Neurostimulation and the American Psychiatric Association.