• Change to pentylenetetrazol
(metrazol) (cardiazol)
1938 Ugo Cerletti & Lucio Bini
CURARES
1976 Constant current brief pulse ECT device, the prototype for modern device is developed
Late 1970s-early 1980 Randomized controlled trials reveals ECT is more effective than sham treatment for major
depression
The beliefs of seizure is sufficient for clinical response is challenged by H.A Sackheim and
1987 his collaborators, who reported that the combination of dosage just above seizure
threshold and right unilateral electrode placement while producing a seizure of
sufficient duration, is ineffective
YEAR EVENT
1998 Randomized controlled clinical trials of ECT vs Lithium: equally effective in mania
2000
Controlled trials of the dose response relationship for the right unilateral ECT is validated.
High dose right unilateral and bilateral ECT show equal response rate in MDD but right
unilateral electrode placement is associated with fewer adverse cognitive effect.
Convulsive treatment is induced with magnetic stimulation by S.H Lisanby and her colleagues
2001 Largest model controlled trials of relapse prevention post-ECT with continuation
pharmacotherapy has significant better outcome with TCA (nortryptyline) plus Lithium
compared with nortryptyline alone or placebo during 6 months post-ECT
MECHANISM OF ACTION:
- Generally, linked with production of GTCS
ANAESTHESIA
• General anaesthesia and oxygenation. Depth of anaesthesia should be
as light as possible.
MUSCLE RELAXANT
• To minimize the risk of bone fractures and other injuries resulting from
motor activity during the seizures
• The goal is to produced profound relaxation of the muscles.