Posted by linkadge on July 30, 2003, at 21:02:10
In reply to Re: Actually no, posted by Psychquackery on July 30, 2003, at 18:49:15
You are taking something that has scientists have absolutely no idea how works and you are trying to assign meaning and science behind it that just doesn't exist.
The reason they call it ElectroCONVUSIVETherapy is because thats what the procedure is, and thats how they've been doing it. Just because they've been doing it a certain way, with a certain procedure, does not mean the whole shibang is necessary.For instance we can induce seizures quite safely using a magnesium restricted diet and glutimate receptor antagonists. This is one approach that has been used to try and replicate the effect of ECT. It produces full Grand Mal seziures. The stradegy was abandoned because it did nothing for depression. ( only induced memory loss. )
Insulin shock therapy is again a totally different procedure that we separately don't understand. We cannot say that it works in the same way as ECT if we don't really know how ECT works now can we???
You are inserting information into the equation that just never existed. You ask any of the top scientists why ECT works and they'll tell you they don't have a clue.
We know some of the results of it though.
- Both ECT and rTMS decrease gluticorticoid
expression- Both ECT and rTMS upregulate NGF, BDNF, GDNF
and other nerve growth factors in rat brain.- Both ECT and rTMS alter 5HT1a/b autoreceptors.
- Both ECT and rTMS alter norepinephrine
expression.- Both ECT and rTMS increase bloodflow to left
prefrontal lobe.- Both ECT and rTMS have effects on substance P
NK-1 receptor expression.Infact find a observable brain alteration induced by ECT that is not also induced to a certain degree by rTMS.
If you think that ECT is the only way that we can safely evoke seizures these days, that is just not true. If scientists really thought that ECT's sole mechanizm was through inducing a seizure then the direction of our research would change completely. We would've abandoned this direction completely. Not only are many (specific) pro-convulsant drugs useless for psychiatric conditions, they also induce short term memory loss - so go figure - that accounts for one side effect.
Many scientists simply think that the seizure is just a marker, that certain neronal stimulation has been reached. How do you know that the theraputic effect is not reached moments before the seizure? There is no way to know (yet at least)How can you say rTMS is a weaker version of ECT when we don't know how either work? Again, you're inserting info into the equation. Most people who use rTMS agree that it is still in its intfant stages. I would agree with you when you say at 'this time', it is less effective than ECT, because that's just the statistics. For instance, certain frequencies facilitate neurotransmitter release, and other frequencies impede neurotransmitter release. Scientists are basically just poking around and recording what happens.
I know you want to make it into some solid and fully researched/understood procedure, but it is just not.
Some researchers believe that the sucess of ECT is based on its ability to modulate gluticorticoid expression. The drug RU-486 is the only drug to be fast-tracked for a psychiatric condition. It has extreme efficacy in severe and debilitating psychotic depression (Even in persons where ECT has failed)
Could it be that this is the common mechanism. (A mechanism that is equally pronounced in both ECT and rTMS). You cannot say no - because we don't know.
Linkadge
poster:linkadge
thread:246432
URL: http://www.dr-bob.org/babble/20030728/msgs/246880.html