Skip to main content
CLP 2021 Annual Meeting Main banner
Final Program


Back
Evaluation Video

Neurocognitive Disorders, Delirium and Neuropsychiatry

Session:: Skills Course

ECT for C-L Psychiatrists: An Effective Intervention That Might Save a Life

On Demand
CE: 2
Electroconvulsive Therapy (ECT) is an effective, rapidly acting treatment for many psychiatric conditions including depression, mania, and catatonia. It is a key component of modern psychiatric care, providing relief of sometimes life-threatening symptoms for which no other therapies are effective. ACLP recognizes the need for ECT training: “The C-L psychiatrist must be knowledgeable about electroconvulsive therapy (ECT) and recognize when to introduce it in depressed, catatonic, or critically ill patients” (Bronheim, Fulop, Kunkel, et al; 1998). Because many patients seen by C-L psychiatrists have comorbid medical conditions that may be disabling and that can be made worse by one or more psychiatric conditions, rapid treatment and resolution of these conditions is essential to optimal patient care.

This course will introduce C-L clinicians to ECT or serve as a refresher course for C-L clinicians familiar with its use and will show how it may be used in medical and surgical patients while addressing the legal, ethical, and physiological parameters that must be considered when providing a course of ECT for complex patients. We will also discuss the challenges faced by ECT recipients and providers during the COVID-19 pandemic. Several cases that illustrate the many ways ECT can be used successfully by C-L Psychiatrists will be presented.

This Skills course will cover the following topics:

Dr Rabinowitz
-Background and history of ECT
-ECT technique

Dr Lewicki
-Basic science of ECT
-Hypothesized mechanisms of action

Drs Eyler & Odefey
-Work-up of the medical/surgical patient
-Anesthesia technique & physiological response to electrically induced seizures
-Role of the anesthesia provider in optimizing treatment success and preventing complications
-Protecting patients and treatment team from viral exposure during the COVID-19 pandemic
-Special considerations for evaluating candidates for ECT via telemedicine

Drs Knight and Lewicki
-Some diagnoses/conditions/cases in the general hospital that might benefit from ECT:
*Expectant mother with life-threatening psychosis
*Catatonia
*Delirium
*Medical conditions predictive of ECT use
*ECT for our soldiers

Learning Objectives:

  • Describe the essential components of a pre-ECT evaluation and of patient preparation for ECT
  • Discuss how an ECT service can safely and effectively adapt to the challenges posed by the COVID-19 pandemic
  • Describe some emergency situations or conditions where ECT may be the treatment of first choice