Index [assets.cambridge.org]assets.cambridge.org/97805218/83887/index/9780521883887...Index abortive seizures, 474 Abrams, Richard, 171, 173, 175 ACC. See American College of Cardiology
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Index
abortive seizures, 474Abrams, Richard, 171, 173, 175ACC. See American College of CardiologyACGME. See American Council on Graduate
Medical Educationacroagonine, 176ACT. See Association for Convulsive TherapyACTH. See adrenocorticotropic hormoneactivity regulated cytoskeleton (Arc) genes,
62–63acute catatonic schizophrenia, ECT for, 131–133
benzodiazepines v. ECT for, 132, 133remission rates for, 132–133
acute onset delirium, 435–436acute schizophrenia, ECT for, 127–131
antipsychotic drugs v., 127–128remission rates for, 127trial studies for, 128–130, 131
Aden v. Younger, 210, 219adrenocorticotropic hormone (ACTH), 153Advocates for Humanity, 217AF. See atrial fibrillationage of patient, ECT use and, 231
in Asia, 260AHA. See American Heart AssociationAll’s Well That Ends Well (Shakespeare), 384Almansi, Renato, 227Alonso, Rafael J. Larragoiti, 281ambulatory electroconvulsive therapy, 515–518
ACT guidelines for, 516–517development of, 515–516
ambulatory insulin therapy, 25American Academy of Child and Adolescent
Psychiatry, 499American College of Cardiology (ACC), 402
CAD/post-MI guidelines under, 404American Council on Graduate Medical
Education (ACGME), 199–200American Heart Association (AHA), 402
CAD/post-MI guidelines under, 404American Journal of Psychiatry, 212, 413American Psychiatric Association (APA), xxi,
208ECT guidelines under, in state regulations, 202
blind v. nonblind studies for, 114–116dosage issues in, 116meta-analyses failures in, 117new medications in, 116with outmoded techniques, 116variability in diagnoses in, 116–117
VNS as alternative to, 549anti-ECT movements, 212–214. See also Church
of Scientology; Hubbard, LafayetteRonald
Coalition for the Abolition of Electroshock in,214
Coalition to Stop Electroshock in, 214, 215development of, 214Hubbard role in, 212–213Insane Liberation Front in, 214International Coalition for the Abolition of
Electroshock in, 214Mental Patients Liberation Project in, 214NAPA in, 214, 215in Russian Federation, 268in Scandinavia, 237
antipsychiatry opponents, ECT and, 198. Seealso Church of Scientology; CitizensCommission on Human Rights
National Anti-Shock Action, 249U.S. state regulations and, influence on,
203–204antipsychotic drugs, xvii. See also hypofrontality
for acute schizophrenia, 127–128
for chronic schizophrenia, with ECT, 136–138death rates and, 371for depression, v. ECT, 351–352in DSM-IV, 363ECT v, xvii, 362–379
books and films, ECT in, 180–195, 211–212An Angel at My Table, 182–183, 193The Bell Jar, 184–185, 188, 193Electroboy, 190Family Life, 188Fear Strikes Out, 191–192, 193Frances, 188, 192Holiday of Darkness, 188–189legislation influenced by, 210–211Memoirs of an Amnesiac, 183One Flew over the Cuckoo’s Nest, xviii, 172,
188, 191, 192, 210, 321Out of Tune, 193in professional literature, 211psychiatrists negatively influenced by, 198psychiatrists’ portrayals in, 210Shadowland, 192Shine, 193Shock: The Healing Power of Electroconvulsive
CAD. See coronary artery diseasecaffeine, stimulus potentiation and, xxixCanada, ECT use in, 198–199cancer, from antipsychotic drugs, 371–372capacity. See mental capacitycardiovascular disorders, ECT with, 402
anticoagulation and, 406CAD, 404
ACC/AHA guidelines for, 404medication treatment guidelines for, 404
CHF, 402–404decompensated, 403patient evaluation for, 403treatment for,
in Russian Federation, early use of, 266chemical convulsive therapy, 167CHF. See congestive heart failure, ECT withchildhood/adolescent psychoses, catatonia and,
141–142children/adolescents, ECT in, 498–503
adverse events with, 502–503tardive seizures, 502
cognitive effects of, 502–503patient assessment for, 499–501
NICE guidelines for, 499physical fitness as factor in, 500treatment needs in, 499–500
rates of use for, 498–499seizure thresholds with, 501stimulus dosage for, 501–502techniques for, 501–502
Chile, ECT use in, 281choroid plexus, 58chromatin remodeling, 58chronic DBS, 557chronic schizophrenia, ECT for, 136–138
antipsychotic drugs and, 136–138definition of, 136effect of catatonic features after, 138
Church of Scientology, 187, 208, 212, 217. Seealso Hubbard, Lafayette Ronald
CCHR and, 187, 208, 213psychiatry and, 212
Citizens Commission on Human Rights(CCHR), 187, 208, 213
Clinical Antipsychotic Trials of InterventionEffectiveness (CATIE), 372
CME. See continual medical educationCNS. See central nervous systemCoalition for the Abolition of Electroshock, 214Coalition to Stop Electroshock, 214, 215Columbia University Consortium (CUC), 174competency, 393–394
determination of, 393legally relevant criteria for, 395–396MacCAT-T for, 393
congestive heart failure (CHF), ECT with,402–404
decompensated, 403patient evaluation for, 403treatment for,
Consortium for Research in ECT (CORE), 174mECT study by, 520
Donahue, Anne B., 194dopamine hypothesis, 76. See also schizophreniadopaminergic pathways, 51
dopamines, 51dopamines, 51
after ECS, 51HVA, 51hypothesis, 76receptors, 51
drugs, antipsychotic, xvii“dry shock,” 33DSM-IV-TR. See The Diagnostic Statistical
manual of Mental Disorders, 4th EditionDTI. See diffusion tensor imagingDukakis, Kitty, 191, 194, 208, 212Dukakis, Michael, 208Duke, Patty, 208Dutch Association for Psychiatry, 249DWI. See diffusion weighted imagingdysexecutive syndrome, 366dysrhythmias, with ECT, 404–405
AF as, 404–405ECG for, 405
dysthymic order, 530dystonia, 557
EAAC1. See excitatory amino acid carrier 1ECG. See electrocardiogram, with ECTechocardiograms (ECG), with ECT
for cardiovascular disorders,for dysrhythmias, 405
ECS. See electroconvulsive shockECT Accreditation Service (ECTAS), 241ECTAS. See ECT Accreditation ServiceECT Handbook, 239, 241–242EEG. See electroencephalography, with ECTEFFECT, 252electricity
ECT and, 3–15on brain tissue, 6brief-pulse stimulus dose and, 9–11, 12–13conversion of energy in, 3dynamic impedance and, 6seizure generation and, 6–8sine wave stimulus dose and, 11, 12–13stimulus efficiency in, 3stimulus generators, 4–5toxic dosage range with, 5–6
hypothesized mechanisms of action, for ECT,and, 82–89
blind v. nonblind studies for, 114–116dosage issues in, 116meta-analyses failures in, 117new medications in, 116with outmoded techniques, 116variability in diagnoses in, 116–117
for anxiety disorders, 343–344antidepressants v., 348–349indications for, 344–345patient selection for, 344for prevention of, 346–347
APA Task Force on, 173, 200, 358, 516guidelines under, 202
in Argentina, 280throughout Asia, 256–264
age as factor for, 260gender as factor for, 261history of, 256indications for, 259–260professional publications about, 263–264rates of use for, 256–259, 263regulation of, 262technical aspects of, 261–262training guidelines for, 262–263
in Belgium, 246–248benzodiazepines v., for catatonia, 376–377in books and films, 180–195
An Angel at My Table, 182–183, 193The Bell Jar, 184–185, 188, 193Electroboy, 190Family Life, 188Fear Strikes Out, 191–192, 193
Frances, 188, 192Holiday of Darkness, 188–189Memoirs of an Amnesiac, 183One Flew over the Cuckoo’s Nest, xviii, 172,
188, 191, 192, 210, 321Out of Tune, 193Shadowland, 192Shine, 193Shock: The Healing Power of
for cerebrovascular disease, 408with CHF, 402–403, 404in children/adolescents, 498–503
adverse events with, 502–503cognitive effects of, 502–503patient assessment for, 499–501rates of use for, 498–499seizure thresholds with, 501stimulus dosage for, 501–502techniques for, 501–502
in Chile, 281for chronic schizophrenia, 136–138
antipsychotic drugs and, 136–138definition of, 136effect of catatonic features after, 138
EFFECT for, 252electrode placement variation in, 252history in, 246
throughout Europe, 246history in, 246
evaluation after, 505–512fractures as result of, 209in France, 248Friedberg opposition to, 213–214future applications of, 176in Germany, 248–249history of, 167–176
current application reduction in, 170–171electrode placement in, 170, 173–175Meduna in, 18, 168memory loss in, 169oxygenation in, 171–172within physical therapies, 167psychopharmacology in, 172restraint development in, 169Sakel in, 18, 167–168
in Hong Kong, 256hormonal effects of, 149–161
ACTH, 153comparison of changes in, 151–153consequences of, 150–151cortisol release, 159–160future research applications with, 160–161posterior pituitary, 158–159prolactin, 152, 153–158resting hypercortisolism and, 159as temporary, 149
in hospital programs, 201model policy guidelines for, 287–294, 313for patients from other facilities, 306–308
electroconvulsive therapy (ECT) (cont.)anticonvulsant theory of, 78background of, 75development of, 79–89diencephalic theory of, 77–78functional consequences of, 85–87neurochemical theories of, 75–77neuronal network function restoration in,
87–89seizure generalization theory and, 79, 89
with ICDs/pacemakers, 405in India, 258informed consent for, xxv–xxvi, 384–398
competency for, 393–394court-ordered treatment and, 397definitions of, 385discussion strategies for, 387–392historical development of, 385hospital programs policy guidelines for,
289–292in Latin America, 279–280legislation on, for ECT use, 215mental capacity for, 393–394mental incapacity and, 393–397obstacles to, 392–397practical strategy methods for, 386–387
in Japan, 257–258throughout Latin America, 276–283
anesthesia with, 279applications of, 278–279history of use in, 276–277informed consent for, 279–280rates of, 279techniques for, 279training for, 280
legislation for, 207–220APA Task Force role in, 214–215for banned use, 208in California, 214–216constructive lawmaking in, 218–219films’ influence on, 210–211history of, 214–218for informed consent, 215litigation cases as basis for, 209–210in Massachusetts, 215proactive, 219state regulations and, 202–204, 233in Texas, 216–218
for anxiety disorders, 344with PD, 407–408personal accounts of, 181–184, 187, 189–191philosophy for use of, 341–342physical suite layout for, 314–321
anesthetists in, 323–324design considerations for, 321for high-volume operations, 316
IV access considerations in, 317–319nurses in, 322–323outpatient considerations for, 319pretreatment personnel in, 322psychiatrists in, 323for recovery rooms, 320–321in small hospitals, 315–316for small-volume operations, 315–316surgical operating rooms and, 314for treatment rooms, 319–320
patient management in, xxixpre-ECT protocol, xxv–xxx
atropinic agents in, xxviwith benzodiazepines, xxviielectrode placement in, xxviiiintramuscular medication in, xxv–xxvimuscle relaxants in, xxviinarcosis agents in, xxvi–xxviioral medications in,oxygenation during, xxviiphysiological monitoring for, xxixsedation for sleep on night before, xxvistimulus dose method in, xxviiistimulus potentiation in, xxviii–xxix
during pregnancy, 409as prerequisite for other procedures, 357prevention of mental illness, xviifor prevention of threatening experiences,
xvii–xviiibipolar disorders, xviiiPTSD, xviii
psychiatrists’ response to, 197–205in Canada, 198–199legislative regulations against, 202–204malpractice concerns, 204as molded by negative film portrayals,
198as professional mindset, 204–205sociopolitical barriers to, 201–202training issues with, 199–200in treatment patterns, 198, 200–201in U.S., 198–199
anti-ECT movement in, 268chemical convulsants and, in early use of,
266contemporary applications of, 271–272device development in, 271early history of, 266–270“Meduna’s method” and, 266Moscow Society of Neurologists and
Psychiatrists in, 270for nonpsychiatric conditions, 272political influence on, 267–268psychiatry in, under Stalin, 267Soviet Scientific Society of Neurologists
and Psychiatrists in, 268in Scandinavia, 236–238
anti-ECT movement in, 237future applications for, 243history of, 236rates of use for, 236–237research tradition and, 238training for, 242
for schizoaffective disorders, 135–136psychosis and, 355
augmentation strategies for, 458–459Benchmark Method for, 456–458case studies of, 461–463
cognitive side effects of, 454–455for depression, 450–454, 455–456electrode placement and, 459–460with mECT, 460–461, 522schedule for, 452sham studies for, 449units of measure for, 447–449waveform morphology for, 449–450
in Taiwan, 256–257tardive psychosis for, 369in Thailand, 257TMS v., 36, 534–535
training issues with, 199–200for nonpsychiatric physicians, 199during psychiatric residency, 199–200
treatment for, xviiiin UK, 238–242
contemporary standards and practices for,241–242
ECT Handbook in, 239, 241–242future applications for, 243under NICE, 240–241pre-NICE standards and practices, 238–240training for, 242–243
in Uruguay, 282in U.S., 198–199, 209–210, 227–234
academic medical centers as factor for, 229age as factor for, 231APA guidelines for, 228demographic variation in, 231–232for depression, 228–229ethnicity/race as factor in, 232excessive use of, 209future applications for, 233–234gender as factor in, 231–232inpatient v. outpatient status and, 230–231insurance access as factor for, 232–233legislation for, 207–220litigation over, 209–210overuse of, 209in public v. private hospitals, 230regional/state variation for, 229service sites for, 230–231service system variation for, 229–230small-area analysis for, 228–229socioeconomic factors for, 232–233state regulations over, 202–204, 233usage trends for, 227variation of, 228
with VNS, 549–550electrodes, placement of, 430–444
Europe, ECT treatment throughout, 246. Seealso Belgium; France; Germany; TheNetherlands; Portugal, ECT use in;Spain, ECT use in
EFFECT for, 252electrode placement variation in, 252history in, 246
excitatory amino acid carrier 1 (EAAC1), 52
Family Life, 188FDA. See Food and Drug AdministrationFear Strikes Out, 191–192, 193FGF-2 genes, 62fibromyalgia, 577films, ECT in. See books and films, ECT inFink, Max, 173, 174, 238Finland. See Scandinavia, ECT as treatment inFirst International Meeting on Modern
Fontanarrosa, Orlando y, 280Food and Drug Administration (FDA), 287Forman, Milos, xviii, 172Foucault, Michel, 172fractures, from ECT, 209Frame, Janet, 182–183, 193France, ECT in, 248
training issues with, 248Frances, 188, 192Frank, Leonard Roy, 214Friedberg, John, 211, 212
opposition to ECT, 213–214Friedman, Emerick, 170frizzled protein (Frz) genes, 64Frz genes. See frizzled protein genesfunctional magnetic resonance imaging (fMRI),
hippocampus, 55depression and, volume as factor in, 65–66
The History of Madness (Foucault), 172Holiday of Darkness (Endler), 188–189Holmberg, Carl Gunnar, 170, 413homovanilic acid (HVA), 51Hong Kong, ECT use in, 256hormones, ECT effect on, 149–161
informed consent, for ECT (cont.)discussion strategies for, 387–392
for adverse side effects, 391APA Task Force report on, 392for consent process, 387–389for ECT v. other treatments, 389–390for nature of illness, 389physician’s role in, 389for risk factors, 391–392for treatment/posttreatment, 389,
390–391historical development of, 385
in legal cases, 385Parens Patriae doctrine and, 385
hospital programs policy guidelines for,289–292
in Latin America, 279–280legal applications of, 385–386
in malpractice cases, 385State of California Welfare and Institutions
Code for, 386legislation on, for ECT use, 215
model for, 218in Texas, 216–217
mental capacity for, 393–394determination of, 393legally relevant criteria for, 395–396
mental incapacity and, 393–397National Quality Forum for, 394
obstacles to, 392–397with competent patients, 392mental incapacity as, 393–397
practical strategy methods for, 386–387Inglis, James, 174, 443Insane Liberation Front, 214The Insulin Myth, 27insulin therapy, after coma inducement, 18,
24–28ambulatory, 25application procedure for, 25with chemical convulsants, 28–30
application procedures for, 29complications from, 29–30indications for, 29
complications of, 28fatalities as, 28
convulsive factor in, 33–34“dry shock” from, 33epileptiform phenomena in, 33glucagon in, 25historical background of, 24–25, 167–168indications for, 25–27“moist shock” from, 33outcomes from, 21patient fear of, 31–33
legislation, for ECT use, 207–220APA Task Force role in, 214–215for banned use, 208in California, 214–216constructive lawmaking in, 218–219films’ influence on, 210–211history of, 214–218for informed consent, 215
model for, 218in Texas, 216–217
litigation cases as basis for, 209–210overregulation as result of, 210
in Massachusetts, 215proactive, 219in Texas, 216–218
for informed consent, 216–217Texas Society of Psychiatric Physicians
influence on, 216Leicestershire trial, 118, 449lesions. See intracranial space-occupying lesions,
mental capacity, 393–394determination of, 393legally relevant criteria for, 395–396
mental disordersECT as treatment for, 89organizational levels of brain and, 80–82,
89structural abnormalities in, 81–82
mental incapacity, 393–397National Quality Forum for, 394
Mental Patients Liberation Project, 214“The Merry Pranksters,”Mexico, ECT use in, 281–282Meyer, Adolph, 18Meyers, Jeffrey, 186MI. See myocardial infarction, with ECTMini Mental State Examination (MMSE), 435,
minors, ECT use for, 294–295missed seizures, 473–474Mitchell v. Robinson, 209mivacurium, 420MMSE. See Mini Mental State ExaminationMoench, Louis, 173“moist shock,” 33Molohov, A.I., 267monoamine hypothesis, 76monoamine systems
depression from depletion of, 46hypothesis for, 76
Montgomery-Asberg Depression Rating Scale,346
mood disorders, 76. See also antidepressantmedications; depression
chemical convulsive therapy for, 167depression
brain stimulation applications for, 68diencephalic theory and, 77ECT for, 45, 109–120hippocampal volume and, 65–66HRSD for, 103monoamine depletion and, 46NE and, 49–51NPY neuropeptide and, 53PTZ for, in non-ECT therapy, 21–22serotonergic pathways and, 47–49
ECT for, 109–120antidepressant medications v., 114–115,
117for mania, 119–120placebo trials v., 109–112, 114response rates for, 109, 110for subtypes of depression, 117–119variety of treatments in, 117
mania, ECT for, 119–120symptoms of, 77–78
Morgan, Robert F., 212Moscow Society of Neurologists and
myocardial infarction (MI), with ECT, 404ACC/AHA guidelines for, 404medication treatment guidelines for, 404
Myth of Mental Illness (Szasz), 172
NAPA. See Network Against Psychiatric Assaultnarcosis agents, xxvi–xxviiNash, John, 211National Anti-Shock Action, 249National Institute for Clinical Excellence
for depression, 21–22ECT replacement for, 23–24indications for, 20–22
illness duration and, 20outcomes from, 21patient fear of, 31–33psychological impact from, 32–33relapse rates for, 21remission rates from, 20–21for schizophrenia, 20–21
insulin therapy v., 26PET. See positron emission tomographyphenytoin, 35physical suite layout, for ECT, 314–321
anesthetists in, 323–324design considerations for, 321for high-volume operations, 316IV access considerations in, 317–319nurses in, 322–323outpatient considerations for, 319pretreatment personnel in, 322psychiatrists in, 323for recovery rooms, 320–321
nurses in, 324–325in small hospitals, 315–316for small-volume operations, 315–316surgical operating rooms and, 314for treatment rooms, 319–320
physical therapies, 167. See alsoelectroconvulsive therapy
chemical convulsive, 167insulin, for schizophrenia, 26, 167malarial-fever therapy, 167
physicians, nonpsychiatric, ECT training for,199
placebo trialsECT v., for mood disorders, 109–114,
111–112anesthesia induction and, 113–114HRSD scores in, 110–113Northwick Park trial, 113, 118, 449
Leicestershire Trial, 118, 449Plath, Sylvia, 184–185, 188, 211, 413Ploticher, A.I., 268PM-1090. See tetramethyl-succinamidepneumonia. See aspiration pneumoniaPOA. See power of attorneyPortugal, ECT use in, 250–251Positive and Negative Syndrome Scale (PANSS),
530positron emission tomography (PET), 94
during ictal period, with ECT, 97–98during interictal period, with ECT, 102VNS under, 544
psychotic disorders. See catatonia; schizophreniapsychotic melancholia, 353PTSD. See post-traumatic stress disorderPTZ. See pentamethylenetetrazol, in non-ECT
therapypublic hospitals, ECT use in, 230. See also
psychiatric hospital programs, ECT in
race, ECT use and, 232Ramirez Moreno, Samuel, 281reboot theory, of ECT, xxiii–xxv
anticonvulsant activity in, xxvpreexisting psychiatric illness in, xxiiiseizures’ role in, xxiii
grand mal, xxiii–xxivneurotransmitter depletion/replenishment,
rocuronium, 421Rosenberg, Leon, 208Rotshtein, G.A., 266Rozhnov, V.A., 433Rubio y Yarza, Mauricio, 281Russian Federation, ECT use in, 266–273
anti-ECT movement in, 268chemical convulsants and, in early use of,
266contemporary applications of, 271–272device development in, 271early history of, 266–270“Meduna’s method” and, 266Moscow Society of Neurologists and
Psychiatrists in, 270for nonpsychiatric conditions, 272political influence on, 267–268psychiatry in, under Stalin, 267Soviet Scientific Society of Neurologists and
from TMS therapy, 535selective serotonin reuptake inhibitors (SSRIs)
with antipsychotic drugs, 375–376for anxiety disorders, 342ECT v., for melancholia, 347–348electrode placement and, 433
Sequenced Treatment Alternatives to RelieveDepression (STAR∗D) study, 556
Sereysky, M.Y., 272serotonergic pathways
depression and, 47–49serotonins in, 47–49
serotonins, 47–49ECS and, 47–495-HT, 47–49
Shadowland (Arnold), 192Shakespeare, William, 384Shepherd, Michael, 238Shine, 193“shock-block” method, of ECT, 134Shock: The Healing Power of Electroconvulsive
Therapy (Dukakis), 191, 212shock therapies, 167. See also physical therapiesShock Treatment is Not Good for Your Mind
electrode placement and, 459–460with mECT, 460–461, 522schedule for, 452sham studies for, 449units of measure for, 447–449waveform morphology for, 449–450
suicidality, depression and, 348surgery, ECT analogous to, xviiiSwartz, Conrad, 171, 175Sweden. See Scandinavia, ECT as treatment insynaptic plasticity, after ECS, 64–66, 67
neurotrophic factors for, 64–67structural changes, 65
Szasz, Thomas, 172
tachykinin neuropeptides, 54after chronic ECS, 54
tachykinins neuropeptide, 54Taiwan, ECT use in, 256–257tardive dyskinesia, 370tardive OCD, 368tardive psychosis, 367–369
ECT for, 369tardive seizures, 502Taylor, Michael, 175TCD. See transcranial DopplertDCS. See transcranial direct current stimulationTDMHMR. See Texas Department of Mental
Health and Mental RetardationThe Tender Place (Hughes), 184tetramethyl-succinamide (PM-1090), 24Texas Department of Mental Health and Mental
Retardation (TDMHMR), 217Texas National Association of Women, 218Texas Society of Psychiatric Physicians, 216Thailand, ECT use in, 257theophylline, 424“therapeutic privilege,” 209Thesleff, Stephan, 413Thesleff, Stephen, 170thiopental, 416–417Thoreau, Henry David, 393thyrotropin-releasing hormone (TRH), 63Tierney, Gene, 183–184TIMP-1. See tissue inhibitors of
metalloproteinases-1tinnitus, 533–534tissue inhibitors of metalloproteinases-1
(TIMP-1), 63titrated stimulus dosing, 450–453TMS. See transcranial magnetic stimulationtraining, for ECT, 199–200
in Asia, 262–263in France, 248in Latin America, 280for nonpsychiatric physicians, 199during psychiatric residency, 199–200for psychiatrists, 199–200
in Scandinavia, 242in UK, 242–243
transcranial direct current stimulation (tDCS),573–581
advantages of, 575adverse effects of, 575–576for anxiety disorders, 580clinical applications for, 576–580clinical technique for, 573–575for craving disorders, 578–579for depression, 576–577electrode placement options in, 575for epilepsy, 577–578for fibromyalgia, 577future applications of, 581history of, 573intermittent v. constant-current, 581for PD, 579safety of, 576for working memory, 579–580
transcranial Doppler (TCD), 96during interictal period, with ECT, 102
transcranial magnetic stimulation (TMS),525–537, 573
TRH. See thyrotropin-releasing hormoneTye, Larry, 191, 212
UIHC. See University of Iowa Hospitals andClinics
UK See United Kingdom, ECT as treatmentultrabrief pulse stimulus dose, 14–15
electrode placement with, 14–15United Kingdom (UK), ECT as treatment in,
238–242contemporary standards and practices for,
ECTAS within, 241ECT Handbook in, 239, 241–242future applications for, 243under NICE, 240–241pre-NICE standards and practices, 238–240training for, 242–243
United States (U.S.). See also legislation, for ECTuse
ECT use in, 198–199, 209–210, 227–234academic medical centers as factor for, 229age as factor for, 231APA guidelines for, 228demographic variation in, 231–232for depression, 228–229ethnicity/race as factor in, 232future applications for, 233–234gender as factor in, 231–232inpatient v. outpatient status and, 230–231insurance access as factor for, 232–233litigation over, 209–210overuse of, 209in public v. private hospitals, 230regional/state variation for, 229service sites for, 230–231service system variation for, 229–230small-area analysis for, 228–229socioeconomic factors for, 232–233usage trends for, 227variation of, 228
EMTALA in, 287legislation, for ECT use in, 207–220
APA task force role in, 214–215for banned use, 208in California, 214–216constructive lawmaking in, 218–219films’ influence on, 210–211history of, 214–218for informed consent, 215litigation cases as basis for, 209–210in Massachusetts, 215proactive, 219in Texas, 216–218
state regulations in, against ECT use, 202–204in Texas, 202–203
University of Iowa Hospitals and Clinics(UIHC), 317
Uruguay, ECT use in, 282APA guidelines for, 282
U.S. state regulations, against ECT use, 202–204,233
antipsychiatry groups’ influence on, 203–204APA guidelines in, 202in Texas, 202–203
for depression, 546–548clinical outcomes for, 547MDD, 547trial studies for, 547–548
for epilepsy, 543, 546future applications for, 552indications for, 546–549mechanisms of action for, 543–544neurochemical changes from, 544neurophysiological changes from, 543–544under PET, 544during pregnancy, 550under SPECT, 544surgical implant procedure for, 544–545Therapy Pulse Generator in, 544–546
device parameters for, 550programming for, 545–546
therapy system for, 544–546for treatment-resistant depression, 543, 549
valvular disease, ECT with, 406VAMP2 gene. See vesicle-associated membrane
protein genevascular disease, ECT with, 405–406vasopressin, 158–159Vedak, Chandra, 171VEGF genes, 62vesicle-associated membrane protein (VAMP2)