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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Denise1966 on June 26, 2005, at 9:59:42
Hi,
I was just wondering if ECT Treatments are superior in the States than they are in the UK as I think Ed_uk mentioned they were different.
And is there any evidence of this?
Also, where is the best place in Europe to have it, Sweden?
Kind Regards......Denise
Posted by ed_uk on June 26, 2005, at 11:08:42
In reply to Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 9:59:42
>I think Ed_uk mentioned they were different.
I did?
You do need to make sure that the ECT you're having is 'high quality'. Apparantly, some centres don't even monitor the EEG - they use the useless 'cuff' method instead. You need to make sure that the clinic you go to is accredited by the Royal College of Psychiatrists.
http://www.priory.com/psych/ectolectas.htm
http://www.rcpsych.ac.uk/cru/ECTASstandardsDec04.pdf
Personally, if I was to need ECT, I'd only have it done at a clinic rated 'excellent' ie. all criteria fulfilled, type 1, 2 and 3. Only 'type 3' clinics monitor the 2 channel EEG!
http://www.rcpsych.ac.uk/cru/ECTAS.htm
'Its (the UK Royal College of Psychiatrists) most recent report in 1999 rated only a third of clinics in England and Wales as good. It also found that junior doctors were often left unsupervised and many ECT machines were outdated.
Dr Benbow admitted that ECT practice had not always been found to meet RCPsych guidelines.
"At present you should have a consultant in charge of the ECT clinic overseeing the technicians and junior doctors administering the treatment to ensure it is up to scratch," she said, adding: "However, audits have found that some consultants spend very little time in these units, so if you accredit them that might not have much impact upon standards."
The college had considered adopting the US regulatory system of accrediting ECT practitioners, revealed Dr Benbow, but its preferred option was accrediting the clinics instead. This would bring poorly performing units under its scrutiny and make them liable to face sanctions up to and including closure.'
Btw, you're right about maintenance ECT in the UK. NICE (National Institute for Clinical Excellence) has recommended that maintenance ECT should not be used in the UK. Nevertheless, doctors or not obliged to follow these guidelines if they don't want to. I think it would be fair to say that most pdocs would refuse to give you maintenance ECT though.
'A leading Scottish psychiatrist has pledged to flout government guidelines and continue to give depressed patients regular electric shock treatment for periods of several years.
Dr Donny Lyons, consultant in electroconvulsive therapy (ECT) at Leverndale Hospital in Glasgow, has warned that he will ignore new guidelines, that the procedure should only be given in short courses, whenever he thinks it would be against a patient's interest.
He said: "If I have a choice between following these guidelines and doing what I think is best for my patients, then I will do the latter. I am not going to tell my patients they cannot have this treatment because Nice [the National Institute of Clinical Excellence] advises against it. My duty to patients will take precedence. I have no difficulty deciding not to follow the guidelines because I do not think they are correct. I would be very unhappy if my ability to help people is impeded by guidelines that don't make any sense."'
~Ed
Posted by Denise1966 on June 26, 2005, at 11:35:18
In reply to Re: Is ECT really superior in the States to the UK » Denise1966, posted by ed_uk on June 26, 2005, at 11:08:42
Hi Ed,
Thanks for this, I had contacted the Royal College of Psychiatrists about the ratings and the lady told me they hadn't been published yet. I can't see anything in any of the literature you've sent me so I expect they've still not been published.
The psychiatrist who I saw the other day told me that Queen Elizabeth Psychiatrics hospital in Birmingham was very good and that they do do EEGs there, the only let down was something about the waiting room being shared which I'm not too bothered about. I'll contact the Royal College again anyway just to see if they have the results.
Whereabouts in the UK are you? What's your diagnosis and what meds are you currently taking?
Denise
Posted by Jazzed on June 26, 2005, at 11:42:33
In reply to Re: Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 11:35:18
Isn't there something new with magnets or something like that, that's supposed to be better, and not quite as drastic as ECT? Denise are you thinking about ECT? Is it a last ditch effort to cure depression? I'm so sorry if it is. Depression is so overwhelming.
Jazzy
Posted by Nickengland on June 26, 2005, at 11:58:06
In reply to Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 9:59:42
To save any confusion...I think it was me who said ECT is different in England compared to America in my previous post/reply to Denise regarding NHS questions etc..
Kind regards
Nick
Posted by badhaircut on June 26, 2005, at 13:27:28
In reply to Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 9:59:42
I don't know what the trend is in UK or Europe, but according to the last US pdoc who wanted me to try ECT again, *bilateral* ECT is now considered (by his crowd) to be more effective for treatment-resistant depression than *unilateral* ECT. The downside is that bilateral ECT is more likely to produce memory problems.
These are generalities, of course. YMMV.
But it may be something to talk to your potential ECT providers about.
-bhc
Posted by Denise1966 on June 26, 2005, at 13:40:07
In reply to Re: Is ECT really superior in the States to the UK » Denise1966, posted by Jazzed on June 26, 2005, at 11:42:33
Hi Jazzy,
Yes, I think you're referring to rTMS repetative transcranial magnetic stimulation. I went to Vancouver to try that and it was no benefit to me at all.
Thanks anyway....Denise
Posted by Denise1966 on June 26, 2005, at 13:41:17
In reply to ECT unilateral vs bilateral » Denise1966, posted by badhaircut on June 26, 2005, at 13:27:28
Hi,
Thanks yes I've heard that too but I think I'll try the unilateral first at least and then if that doesn't work maybe consider the bilateral.
Kind Regards.......Denise
Posted by ed_uk on June 26, 2005, at 15:55:05
In reply to Re: Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 11:35:18
Hi Denise,
>I had contacted the Royal College of Psychiatrists about the ratings and the lady told me they hadn't been published yet.
Perhaps you could 'google' individual centres eg.
>Whereabouts in the UK are you?
Yorkshire.
>What's your diagnosis and what meds are you currently taking?
OCD. Citalopram 60mg/day.
Kind regards
~Ed
Posted by ed_uk on June 26, 2005, at 15:56:39
In reply to Re: To badhaircut, posted by Denise1966 on June 26, 2005, at 13:41:17
Hi,
>I think I'll try the unilateral first at least and then if that doesn't work maybe consider the bilateral.
.........or you could try bifrontal first and then bitemporal if it doesn't work.
~Ed
Posted by Phillipa on June 26, 2005, at 22:44:20
In reply to Re: To badhaircut » Denise1966, posted by ed_uk on June 26, 2005, at 15:56:39
Google rTMS, and ECT there are a lot of threads in the archives. Fondly, Phillipa
Posted by Sebastian on June 28, 2005, at 19:11:50
In reply to Re: Is ECT really superior in the States to the UK » Denise1966, posted by ed_uk on June 26, 2005, at 11:08:42
This is the end of the thread.
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