Electroconvulsive Therapy

by Richard Abrams

Overview

In this fully-revised fourth edition of what has long been the standard textbook for the field, Dr. Richard Abrams once again demonstrates his unique ability to analyze and present a wealth of new(and often technical) material in a lucid, compelling, and highly readable fashion. Hundreds of new clinical studies called from the more than 1500 published since the third edition appeared have been analyzed in depth and incorporated throughout the book. An important new chapter has been added on Transcranial Magnetic Stimulation(TMS) therapy, a treatment for depression that is widely-used in Europe and expected to become available soon for clinical use in the United States. Dr. Abrams exposes the scientific flaws in several widely-cited reports, while focusing on the few carefully-controlled studies that provide solid support for the results claimed. The sections on the electrical stimulus, seizing introduction, seizure quality, and treatment electrode placement have been completely revised and updated with new information on those clinical and technical issues that are presently of greatest concern to practitioners and researchers. A comprehensive critical assessment of the nature of the seizure threshold and the validity of the stimulus titration method for ECT dosing is presented for the first time, with conclusions and recommendations that many will find surprising. The continued controversy over the relative efficacies of unilateral and bitemporal ECT is revisited in light of the latest dosing strategies and treatment outcomes reported, and of the latest results obtained with bifrontal ECT. The potential clinical and theoretical advantages of the recently-rediscovered technique of ultrabrief pulse therapy are explained in detail. The chapter on the memory and cognitive consequences of ECT has been expanded to focus on the subjective memory effects of treatment, with new analysis of the possible biological basis for the improvement in subjective memory so often reported. Recently-published claims of persistent or permanent memory effects of ECT are refuted in detail. In full accordance with the American Psychiatric Association's new guidelines for the practice of ECT, Dr. Abrams' book remains the essential practical guide and reference work for all those who prescribe, perform, or assist with ECT, or are interested in learning more about the subject.

Product Details

ISBN-13:	9780198033783
Publisher:	Oxford University Press
Publication date:	06/27/2002
Sold by:	Barnes & Noble
Format:	eBook
File size:	956 KB

About the Author

Richard Abrams, M.D., is Professor of Psychiatry at The Chicago Medical School. He has conducted clinical and basic science research on ECT for more than a quarter of a century, during which time he has authored over 70 articles, books, and chapters on the subject. Dr. Abrams is also a widely-respected lecturer, whose many dozens of conferences and workshops on ECT have been enthusiastically received by thousands of practitioners attending them over the years. He has been a member of the Editorial Board of the journal Convulsive Therapy since its inception. Dr. Abrams also has numerous ECT-related patents to his credit, and is President of Somatics, Inc., a firm that manufactures and distributes the Thymatron ECT device.

Table of Contents

1. History of Electroconvulsive Therapy2. Efficacy of Electroconvulsive Therapy3. Prediction of Response to Electroconvulsive Therapy4. The Medical Physiology of Electroconvulsive Therapy5. Electroconvulsive Therapy in the High-Risk Patient6. The Electroconvulsive Therapy Stimulus, Seizure Introduction, and SDeizure Quality7. Treatment Electrode Placement: Bitemporal, Unilateral, Bifrontal8. Technique of Electroconvulsive Therapy: Theory9. Technique of Electroconvulsive Therapy: Praxis10. Memory and Cognitive Functioning After Electroconvulsive Therapy11. Neurobioogical Correlates and Mechanisms12. Patients' Attitudes, Medicolegal Considerations, and Informed Consent13. Transcranial Magnetic Stimulation Therapy (TMS)

Editorial Reviews

3 Stars from Doody

The third edition of this now-standard textbook covers nearly all the relevant issues of electroconvulsive therapy (ECT) and instructs the reader on the medical and technical facts needed to practice this treatment. The new edition, needed to convey the significant advances in the field, is a most valuable contribution to psychiatry and to the patients that need this treatment. The purpose is to improve psychiatrists' understanding and clinical management of patients receiving ECT. Dr. Abrams correctly believes that ""... the time is long past when clinicians giving ECT could just 'push the button' and hope for the best."" He is also correct that most residency training programs fail to instruct their trainees adequately, or at all, in this needed treatment. The intended audience is psychiatrists practicing ECT, particularly older practitioners who have not been able to ""keep up"" and for those recent graduates of psychiatry residency training programs who have not been adequately trained in this treatment modality or have not been trained at all. Topics covered include a historical perspective, review of efficacy studies, prediction of response, medical physiology, the high-risk patient, review of the literature regarding stimulus parameters, unilateral ECT, theory and practice of technical aspects, memory and cognitive functioning issues, neurochemical aspects, patient attitudes, and legal aspects. There is an up-to-date reference section and a useful index at the back of the book. This is an outstanding and comprehensive third edition of Dr. Abrams' textbook on ECT. Any clinician that is involved in the treatment of patients with mental illness should read this book. Allpsychiatry residents should be required to know the relevant topics that this book covers.

Michael J. Schrift

Reviewer: Michael Schrift, DO (University of Washington School of Medicine)
Description: In this fourth edition of his benchmark textbook of electroconvulsive therapy (ECT), Dr. Abrams has updated each chapter with reviews of recent and relevant studies and has added a chapter on transcranial magnetic stimulation therapy (TMS). Dr. Abrams is an internationally renowned clinician-researcher and this book reflects his broad knowledge and wisdom regarding ECT.
Purpose: The purpose is to update information for the practicing clinician. According to Dr. Abrams, "Hundreds of new clinical studies culled from the more than 1,500 published since the third edition appeared have been analyzed in depth and incorporated throughout the book." Indeed, Dr. Abrams has made life easier for clinicians in helping to interpret this vast literature.
Audience: The audience includes practicing psychiatrists, academic and research psychiatrists interested in ECT. It should be mandatory reading for psychiatry residents. Attorneys, forensic psychiatrists, and neuropsychologists involved in legal issues regarding ECT would also find this book useful.
Features: The format of the book's 13 chapters is similar to that of the previous editions, with the addition of the chapter on TMS. Other topics covered include the history of ECT, efficacy, response prediction, physiology, management of the high-risk patient, issues regarding stimulus parameters, seizure induction and seizure quality, electrode placement, theory and practice of technique, cognitive functions, neurobiological correlates, patient attitudes, medicolegal issues and informed consent. The book ends with an exhaustive reference section and a helpful index.
Assessment: This book remains the gold standard for the analysis of the ECT literature and the practicalities of using ECT in clinical practice. I highly recommend it.

Doody's Review Service

"This excellent text is a complete synopsis of the current status of ECT and an important volume to be aware of. The more knowledge the clinician has about the facts of this treatment, the more likely a patient will accept the referral." -University of Washington School of Medicine

From the Publisher