Electroconvulsive therapy seizures from

Lunn RJ, Savageau MM, Beatty WW, et al. Anesthetics and electroconvulsive therapy seizure duration implications for therapy from a rat model. Biol Psychiatry 1981 16 1163-1175. 

Electroconvulsive therapy produces an extraordinary number of physiological and biochemical changes. A central challenge in uncovering mechanisms of therapeutic action is the separation of relevant effects from those that are epiphenomena of generalized seizure activity. This topic was reviewed in detail (Sackeim 1994a). From a practical standpoint, efforts are under way to identify markers of when an optimally therapeutic form of ECT has been administered. 

The electroconvulsive therapy performed in the past is a far cry from the process used today in the treatment of major depressive disorder. In ECT a generalized central-nervous-system seizure is induced by means of an electric current. The objective is to achieve the full seizure threshold until the full therapeutic gains can be established. The exact process by which ECT works is unknown however, the shock results in an increase in different neurotransmitter responses at the cell membrane. Four to twelve treatments are generally given until therapeutic results are noted (Sachs, 1996). 

Electroconvulsive therapy (ECT) of psychiatric disorders occasionally is complicated by trauma to the patient the seizures induced may cause dislocations or fractures. Inasmuch as the rtmscu-lar component of the convulsion is not essential for benefit from the procedure, neuromuscular blocking agents and thiopental are employed. Succinylcholine or mivacurium is used most often because of the brevity of relaxation. 

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