電気けいれん療法

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タイトル別名
  • Electroconvulsive Therapy
  • デンキ ケイレン リョウホウ

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Electroconvulsive therapy (ECT), in which brain seizure discharges are therapeutically induced by transcranial electric stimulation, has been recognized as a treatment for psychiatric disorders including depression, mania and schizophrenia for over 70 years. Many clinical studies have proved its efficacy and safety relative to psychotropic drug therapies. Recent advance in clinical psychiatry has proposed a modification of the ECT procedure, a modified ECT (mECT), in which peripheral muscle relaxant is used to suppress motor manifestations due to the brain seizure discharge. In this article the author carried out a comprehensive review on ECT in respect with its history, clinical indication and practice together with mechanism of action. First, literature review has revealed that indication of ECT is widely described in a variety of disorders. Successful outcome has been reported in the treatment of not only psychiatric disorders but also neurological disorders such as Parkinson´s disease, neuroleptic malignant syndrome or drug resistant chronic pain. Second, the author documented a detailed mECT procedure that has recently been conducted in the department of psychiatry Nihon University School of Medicine. Lastly, clinical considerations on the mechanism of action were made based on recent therapeutic ECT studies using positron emission tomography. Finally the author concluded that the therapeutic effects of ECT involve multiple neurotransmitter systems.

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