Archivist once delivered a course of electro convulsive therapy (ECT) to a 90-year-old patient with severe catatonic depression. This happened every ten years and this had been the course of her illness for over 70 years. After her final burst of electricity, she stood up, thanked me, smiled and walked out of room, back to normal for the next ten years. It was amazing to see the treatment work so well. In 2018, the Food and Drug Administration (FDA) reclassified ECT devices from class III (high risk) to class II (moderate risk, requiring special controls) for use in the treatment of severe major unipolar or bipolar depressive episodes or catatonia in persons 13 years of age or older, whose disorder is ‘treatment resistant or who require a rapid response due to the severity of their psychiatric or medical condition’. How does it work and is it ever used in children and young adults? Castaneda-Ramirez S et al. (Eur Child Adolesc Psychiatry 2022 https://doi.org/10.1007/s00787-022-01942-7) have examined the evidence for ECT use in children in a systematic review on the effectiveness and adverse effect profile of ECT when used for treatment-resistant mood disorders in children and adolescents.
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