Electro Convulsive Therapy; Generally Ignored but Still An Effective Treatment Modality

Abstract

Objective: To compare the efficacy of ECT with those of pharmacological treatment modalities, and to bring to light the continuing usefulness of ECT despite the availability of a number of newer and better medicines. Design: A prospective comparative study. Setting: Department of psychiatry, Combined Military Hospital Pano Aqil Cantt Period From Jan 2003 to March 2004. Subjects and Methods: Patients suffering from Major Depression, Mania, Puerperal Psychosis, and Schizophrenia, were included in the study. Two groups were made. I.e. patients treated with medicines only (group I), and patients treated with ECT alone as first line therapy(Group II). Each group comprised 50 patients. Patients belong to two groups were matched closely regarding their age, sex duration or illness, clinical picture and previous treatment etc. Response to treatment was judged with the help of HDRS in case of depressed patients and clinically only in rest of the patients. Results of the treatment were recorded and comparison made for two groups. SPSS was utilized to obtain statistical significance. Results: ECT proved to be a superior treatment in the achievement of quick remission, especially in those depressed patients with acute onset, psychomotor retardation, psychotic features, and severe disabling anxiety associated with primary illness. Very excited manic patients quickly responded to ECT and calmed down. Catatonic Schizophrenics showed dramatic response, and so did patients with puerperal Psychosis, in achieving early remission. Conclusion: In-spite of misinformation by media, and misconceptions in the minds of lay people, as well as, those related to medical profession, ECT remains a very effective and safe treatment even today. It should be used without hesitation wherever indicated. Limitations of present study need improvement in future studies, in order to achieve more scientifically oriented results. Key words: Efficacy, ECT, pharmacological treatments.