What are the current indications for electroconvulsive therapy?
What are the current indications for electroconvulsive therapy (ECT)?
ECT is generally used for patients with psychiatric indications who have not responded to first-line treatments, such as antidepressants, says ex-GP and psychiatrist Dr Thomas Paterson, the director of the Adelaide Clinic Community Service.
“[ECT] has a place in Status epilepticus, it has a place in neuroleptic malignant syndrome but we don’t use it in those cases,” he says.
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“The indication is someone who is really unwell with a major depressive disorder that is not responding to trials of antidepressants … although there are times when it is a first-line treatment, such as psychotic depression.”
Whereas antidepressants have a success rate of 50-60%, ECT has an 80% success rate. “It is not a cure-all but it the single best biological treatment we have in psychiatry,” says Dr Paterson.
ECT is controlled in different ways in each state. “In South Australia we can use ECT legally for people with depressive disorders, bipolar disorder, mania and schizophrenia,” says Dr Paterson.
