Latar Belakang Pada penanganan klien gangguan jiwa di Rumah Sakit baik kronik maupun pasien baru biasanya diberikan psikofarmaka ,psikotherapi, terapi modalitas yang meliputi terapi individu, terapi lingkungan, terapi kognitif, terapi kelompok terapi perilaku dan terapi keluarga. Biasanya pasien menunjukan gejala yang berkurang dan menunjukan penyembuhan, tetapi pada beberapa klien kurang atau bahkan tidak berespon terhadap pengobatan sehingga diberikan terapi tambahan yaitu ECT Electro Convulsive Therapy. Terapi Elektrokonvulsif disingkat ECT juga dikenal sebagai terapi elektroshock. ECT telah menjadi pokok perdebatan dan keprihatinan masyarakat karena beberapa alasan.
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Electroconvulsive therapy ECT is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments. ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia. It is typically administered by a team of trained medical professionals that includes a psychiatrist, an anesthesiologist, and a nurse or physician assistant.
Does ECT work? Extensive research has found ECT to be highly effective for the relief of major depression. Clinical evidence indicates that for individuals with uncomplicated, but severe major depression, ECT will produce substantial improvement in approximately 80 percent of patients. It is also used for other severe mental illnesses, such as bipolar disorder and schizophrenia. ECT is sometimes used in treating individuals with catatonia, a condition in which a person can become increasingly agitated and unresponsive.
A person with catatonia can seriously injure themselves or develop severe dehydration from not eating or drinking. ECT is also used for people who require a rapid treatment response because of the severity of their condition, such as being at risk for suicide. Although ECT can be very effective for many individuals with serious mental illness, it is not a cure.
To prevent a return of the illness, most people treated with ECT need to continue with some type of maintenance treatment. Before beginning a series of ECT treatments, a patient should receive a thorough psychiatric assessment, including a medical examination and sometimes a basic blood test and an electrocardiogram ECG to check heart health. Informed consent is another important part of the process. A patient must provide written informed consent before ECT is administered.
In situations where a person is too ill to make decisions for him or herself, the consent process is governed by state law for example, a court-appointed guardian. Patients and their families should discuss all options for treatment with the psychiatrist before making a specific treatment decision. They should be provided with sufficient information to fully understand the procedure and the potential benefits, risks, and side effects of each treatment option before providing written consent.
A patient typically receives ECT two or three times a week for a total of six to 12 treatments, depending on the severity of symptoms and how quickly the symptoms respond to the treatment. At the time of each treatment a patient is given general anesthesia and a muscle relaxant and electrodes are attached to the scalp at precise locations.
This causes a seizure within the brain that lasts for approximately a minute. The patient is asleep for the procedure and awakens after minutes, much as from minor surgery. Most insurance plans offering coverage for psychiatric disorders at least partially reimburse the cost of ECT. Like any medical procedure, ECT is has some risks.
ECT treatment has been associated with short-term memory loss and difficulty learning. Some people have trouble remembering events that occurred in the weeks before the treatment or earlier. In most cases, memory problems improve within a couple of months.
Some patients may experience longer lasting problems, including permanent gaps in memory. The risks of general anesthesia, which is needed for ECT, are similar to the risks when anesthesia is used for other procedures such as minor surgeries.
The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours. These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders.
For some patients, the risks of ECT may be less than those of ongoing treatment with medications. ECT can work more quickly than medications. It can be especially useful if a patient is suicidal, is not responding to medications or cannot tolerate the side effects of medication. It involves the use of rapidly alternating magnetic fields to stimulate specific areas of the brain.
TMS typically only has mild side effects including headaches, muscle twitches and pain at the stimulation site. TMS is usually administered four or five times a week for four-to-six weeks. Vagus Nerve Stimulation VNS was developed as a treatment for seizure disorders but can also be used to treat depression that has not responded to other therapies.
Medical use[ edit ] ECT is used with informed consent  in treatment-resistant major depressive disorder , treatment-resistant catatonia , prolonged or severe mania , and in conditions where "there is a need for rapid, definitive response because of the severity of a psychiatric or medical condition e. Results indicated that although patients with unipolar depression and bipolar depression responded to other medical treatments very differently, both groups responded equally well to ECT. Overall remission rate for patients given a round of ECT treatment was About twice as many relapsed with no antidepressants.
What you can expect The ECT procedure takes about five to 10 minutes, with added time for preparation and recovery. So you can expect dietary restrictions before the procedure. Typically, this means no food or water after midnight and only a sip of water to take any morning medications. Your health care team will give you specific instructions before your procedure. You may have a brief physical exam.
What is Electroconvulsive therapy (ECT)?
Awalnya, pasien diberi obat bius ringan dan kemudian disuntik dengan penenang otot. Aliran listrik yang sangat lemah dialirkan ke otak melalui kedua pelipis atau pada pelipis yang mengandung belahan otak yang tidak dominan. Hanya aliran ringan yang dibutuhkan untuk menghasilkan serangan otak yang diberikan, karena serangan itu sendiri yang bersifat terapis, bukan aliran listriknya. Penenang otot mencegah terjadinya kekejangan otot tubuh dan kemungkinan luka.