Shock Therapy

It was my last day in psych and I got to see some interesting stuff. A patient in the unit who suffers from severe depression was found to be a suitable candidate for ECT. A nursing student (an ex-Vetinarian) and myself (an ex-Biochemistry) accompanied her from the unit to the Main Hospital where ECTs are done on the 5th floor. We chatted with the patient. She was nervous, even though this was the second ECT treatment she had received. Once in the room, an anaesthetist proceeded to administer Pentothal and succinylcholine and robinol. In addition, since she was being treated with benzodiazapines for her depression, Romazicon was also administered to lower her seizure threshold. She was administered 50 sec of 80 mA at 220 ohms resistance, which translates to about 176 volts. The entire procedure was followed on a monitor (to watch heart rate and blood pressure) and an EEG to follow the seizure activity. Because of the muscle relaxant, the patient did not 'jump off the bed' when the shock was administered. Furthermore, the major region of the shock was the temporal lobes bilaterally.

The patient regained consciousness soon afterwards in the OR holding room. She did not remember who the nursing student and myself were due to loss of short term memory. Overall, the procedure was nothing spectacular to watch. ECT is administered in a much more humane way these days with appropriate anaesthesia and limiting the major electric disturbance to the region intended. It is still a treatment modality of choice in certain refractory depression and even mania cases.