Re: Advice required for ECT decision

Subject: Advice required for ECT decision

Forum: The Mental Health Forum


Hello
I am seeking advice concerning a proposed ECT course for my father.
He is in his sixties and has not been well for some time. He started going down hill after stress at his work place. Anxiety led to attacks which were variously diagnosed as stress attacks and petit mal episodes.
He began having waking and sleeping nightmares which were vivid and rapidly deteriaoted, he became extremely depressed and paranoid and threatened bizarre sucides. He was then admitted to a mental health ward and it became clear that he could not handle loud noises, people etc, naturally his time there was very bad and we eventually took him out.
This is all going back three years now and since then we have had various diagnoses including Lewy's body disease, head injury, depression anxiety etc etc, He has been on a changing variety of drugs mainly phenabarbotol, a sleeping pill and a variety of anti-anxiety drugs.
He has had good months and bad months, things seemed to be going pretty well when a decent psychiatrist (we have a shortage of pshcys in this country, we are on to number seven now) said Dad seemed to have all the symptoms of post traumatic stress syndrome and started weening him of pills.
Dad looked healthier and seemed better, but in recent months the anxiety is back worse, he is scared to sleep, he startles at the slightest noise meaning he can't drive. the latest psychiatrist has put himback on pills. This is with my father's blessing as he is just plain scared.
Now the doc has suggested ECT and dad is keen because he can see no end and will grasp at anything
We (family) are all nervous about it (cuckoo's nest and all that) but are told it is all much nicer than that. What worries me is that we seem to be constantly offered treatments without knowing what it is being treated.
My father is scared of pain and I have no idea what to tell him or what to watch for (they are proposing an in-house treatment of up to 30)
sorry for rambling on.
any advice would be appreciated
thank you




Ian,
I can understand your concern and frustration about your father's situation.  It is difficult to say what your father's diagnosis is.  I agree it is important to have a diagnosis and this is what determines the treatment plan.  These things should be clarified by your father's psychiatrist and it would be helpful if you were there during the explanation.
ECT (electroconvulsive therapy) is a safe, painless and effective treatment when used with the appropriate diagnosis.  It is most commonly used in mood disorders such as major depression and Bipolar disorder and sometimes in schizophrenia or schizoaffective disorder.   There are few contraindications for ECT.  It has been used safely in pregnant women and in situations where medications are not helpful or maybe harmful such as to the fetus.
ECT is done in a hospital setting, usually in a room where vital signs can be monitored.  An anesthesiologist is present and administers medications that cause sedation and muscle relaxation.  The patient does not recall the procedure and no pain is involved.  After ECT it is not uncommon to have some cloudiness of thought and some times mild memory impairment that is transient lasting a few hours to days.  Generally 5 to 10 treatments every other day (monday, wednesday and friday) is the typical course of treatment but is individualized to response.  I hope this has been helpful.  Please follow up with your father's psychiatrist for further clarification of these issues and the diagnosis.
This information is provided for general medical purposes only.
Sincerely.
HFHS.MD-JM
Keywords:  ECT




Hi
Thnks for your comments, My father has decided to go ahead with the course. basically he sees it is a hope and is tired for drugs. The psychiatrist says the ECT is to treat depression, which she feels is the only illness that dad is suffering from. In her ideal world she would wait for him to be taken off the phenabrbatol and out of his system. But dad is havign very bad nights as the dosage gets reduced to zero.
He is going into hospital today for an overnight assessment and then a first treatment tomorrow and then again two days later. The worrying thing the doc said though is that if he is suffering from some sort of dementia the ect could make it worse?
We can but wait and hope
thanks for your kindness
Ian









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