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Electroconvulsive therapy : ウィキペディア英語版
Electroconvulsive therapy

Electroconvulsive therapy (ECT), formerly known as electroshock therapy and often referred to as shock treatment, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses.〔 It is the only currently used form of shock therapy in psychiatry.
ECT is often used with informed consent as a last line of intervention for major depressive disorder, mania and catatonia.〔FDA. (FDA Executive Summary ). Prepared for the January 27–28, 2011 meeting of the Neurological Devices Panel Meeting to Discuss the Classification of Electroconvulsive Therapy Devices (ECT). Quote, p38: "Three major practice guidelines have been published on ECT. These guidelines include: APA Task Force on ECT (2001); Third report of the Royal College of Psychiatrists’ Special Committee on ECT (2004); National Institute for Health and Clinical Excellence (NICE 2003; NICE 2009). There is significant agreement between the three sets of recommendations."〕
A round of ECT is effective for about 50% of people with treatment-resistant major depressive disorder, whether it is unipolar or bipolar. Follow-up treatment is still poorly studied, but about half of people who respond relapse within twelve months.
Aside from effects in the brain, the general physical risks of ECT are similar to those of brief general anesthesia.〔Surgeon General (1999). (''Mental Health: A Report of the Surgeon General'' ), chapter 4.〕 Immediately following treatment, the most common adverse effects are confusion and memory loss.〔 ECT is considered one of the least harmful treatment options available for severely depressed pregnant women.
A usual course of ECT involves multiple administrations, typically given two or three times per week until the patient is no longer suffering symptoms. ECT is administered under anesthetic with a muscle relaxant.〔Margarita Tartakovsky (2012) Psych Central. (5 Outdated Beliefs About ECT )〕 Electroconvulsive therapy can differ in its application in three ways: electrode placement, frequency of treatments, and the electrical waveform of the stimulus. These three forms of application have significant differences in both adverse side effects and symptom remission. Placement can be bilateral, in which the electric current is passed across the whole brain, or unilateral, in which the current is passed across one hemisphere of the brain. Bilateral placement seems to have greater efficacy than unilateral, but also carries greater risk of memory loss.〔 After treatment, drug therapy is usually continued, and some patients receive maintenance ECT.〔

ECT appears to work in the short term via an anticonvulsant effect mostly in the frontal lobes, and longer term via neurotrophic effects primarily in the medial temporal lobe.
== Medical use ==
ECT is used with informed consent〔 in treatment-resistant major depressive disorder, treatment-resistant catatonia, or prolonged or severe mania, and in conditions where "there is a need for rapid, definitive response because of the severity of a psychiatric or medical condition (e.g., when illness is characterized by stupor, marked psychomotor retardation, depressive delusions or hallucinations, or life–threatening physical exhaustion associated with mania)."〔〔World Health Organisation (2005). (''WHO Resource Book on Mental Health, Human Rights and Legislation'' ). Geneva, 64.〕

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