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Abstract
Summary
This essay reviews the statistical and scientific background about the effect of electroconvulsive therapy on the cognitive functions, the basis of this effect, and the recent ways to avoid these unfavorable side effects.
The discovery of convulsive therapy begins when psychiatrists start to follow the idea that epilepsy and schizophrenia could not exist at the same time in an individual. They tried to induce seizures by any mean ways until dr.Von Meduna succeeded to achieve this by using pentamethylentetrazorl (a soluble synthetic camphor preparation). The electro-convulsive therapy (ECT) was administrated by Cerletti and Bini in 1938 for the first time to avoid the complications of the pharmaco-convulsive therapy.
The controversy and stigma of ECT based on how ECT affects cognitive functions and how this was used for decades in inappropriate way by mass media to show how it is used as a way of punishment and a tool of stealing of mind. For being one of the most available and frequently used therapeutic modalities nowadays, and for being one of the cheapest and most effective therapies in many clinical situations, it was imperative to tackle the ECT-cognitive impairment dilemma in psychiatric patients.
To understand how ECT affect the cognitive functions, this requires thorough knowledge of its mode of action, sites of action and how to use different ECT machines to modify the type and the strength of electric stimulus in its different applications, which the efficacy of ECT and post-ECT adverse effects depend on it.
Cognitive effects are the primary adverse effects and risks of ECT. ECT effects orientation and causes postictal disorientation and confusion. Also it affects general intelligence and executive functions. But the main cognitive side effect was the memory affection and we reviewed in this assay the various studies which concern this affection and the factors which help to induce it. And we noticed from these studies the discrepancies between pro and con observations which helped to develop the controversy in ECT.
We discussed also the clinical neuropsychologic measures and how they help to evaluate the post-ECT cognitive deficits. Also we demonstrated the several factors which can influence them and cause the misleading results if didn’t be knowledge by the practitioner.
The new advances and the modern techniques of ECT administration aimed to minimize these cognitive side effects which were greater in old fashion ones and the make this treatment easy to administrate and helps the patients to continue on their treatment courses. Also we viewed the recent strategies and medications that been suggested in this concern.
Finally we say under the magnification of the nature, extent, and persistence of these effects must always be compared to those of the untreated illness, medications, the consequences of treatment delay, and it can prevent a serious event like suicidal attempts or physical harmful insults.
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