Posted by Psychquackery on July 30, 2003, at 18:49:15
In reply to Actually no, posted by linkadge on July 30, 2003, at 14:54:13
> There is much debate over weather the seizure has anything to do with the efficacy of the treatment. You see the seizure petit/grand mal may only be an indicator that certain relative intensities of current have been met. But as to the seizure itself having any efficay that is actually highly debated.
Again, please put some Medline citations up here to support this claim you have. I dont agree with you and no ECT doc, nor any mainstream clinical psychiatrist would agree with you on the ECT-seizure relationship. There is a DIRECT relationship between quality of the seizure and the effectiveness of the treatment.
Why do you think its called electroCONVULSIVEtherapy? The convulsion, or grand mal seizure, is central to the whole thing. In fact these ECT docs even publish their own ECT journal and what its called? Its titled "Convulsive Therapy."
Some of these researchers involved in the MIBS (Minimally Invasive Brain Stimulation) modalities such as rTMS, VNS implant and Deep Brain Stimulation are trying to prove they can get the same results as conventional ECT can get. They want to stimulate the brain, but do it in a "minimal" and more specific fashion that doesnt result in a seizure. But so far, the results have shown none of these MIBS modalities have anywhere near the effectiveness for severe mood disorders as plain old fashioned bilateral ECT. Bifrontal ECT is also said to be very effective.
In fact, even some of these rTMS researchers are finally beginning to give into the basic fact that if it doesnt cause a seizure, its not going to be very effective for really severe conditions. They have begun experimenting using rTMS magnetism to induce grand mal seizures in refractorily depressed individuals. Its dubbed "MST" or Magnetic Stimulation Therapy." Notice they removed the Convulsive from the acronym, but their objective in MST is to induce a seizure, but with magnetism instead of electricity. They claim this has fewer memory side effects than ECT.
>
> Consider this. We have pro-convulsant drugs that can induce gran/petit mal seizures in the healthy person without the need for electrical stimulation. However, the have absolutely no efficacy in treating depression.
>That is totally untrue. The chemical approach to inducing seizures included insulin shock treatment and some other inhaled chemicals that induced a grand mal seizure. These were effective for the psychiatric conditions and basically resulted in the same results as ECT, but were medically EXTREMELY unsafe. Thats why they were discontinued. Insulin shock was made illegal about thirty years ago (for very good reason BTW) as was the chemical or inhaled methods. In short, it was discovered a long time ago that the safest and most effective method to artificially induce a grand mal seizure is simple electricity!
Petite mal seizures are of no use to treat any psychiatric condition BTW. It must be a generalized, "full body" grand mal seizure to have any worth or effectiveness.
Igor
poster:Psychquackery
thread:246432
URL: http://www.dr-bob.org/babble/20030728/msgs/246861.html