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Electroconvulsive therapy
88%
7/8
Sertraline
0%
0/8
Propofol
Alprazolam
12%
1/8
Psychotherapy
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One of the most common side effects associated with electroconvulsive therapy (ECT) is amnesia. Patients undergoing ECT are given general anesthesia and muscle relaxants, then a generalized tonic-clonic seizure is induced using electrodes. The effectiveness of ECT is based on length of postictal suppression, not on seizure duration, although a minimum seizure duration of 25 seconds is generally desired. ECT is used in treating severe depression, depression in pregnancy, neuroleptic malignant syndrome, refractory mania, and catatonic schizophrenia. ECT typically offers quick relief of symptoms when other treatments modalities are incapable of achieving such results. The amnesia associated with ECT can be either anterograde or retrograde. Little describes the use of ECT in treatment-resistant depression. Depression is said to be treatment-resistant when at least two antidepressants from different pharmacologic classes are unable to produce a clinically significant enhancement. Although ECT is primarily used for treatment-resistant depression, it has also been successfully used for psychotic depression, or when a patient has a contraindication to a certain medication. Bilateral ECT has shown in some studies to improve symptoms more than unilateral therapy. Grover et al. write about the use of ECT in adolescents. Although ECT is infrequently used on the adolescent population (13-18 years old), they found that its use was effective in the treatment of severe psychiatric disorders just as in the adult population. Moreover, the frequency of adverse effects was the same as the adult population. Illustration A depicts the basic set up of ECT. Illustration B shows the difference between unilateral and bilateral stimulation. Illustration V is a video describing ECT. Incorrect Answers: Answer 2: Sertraline is an SSRI that is not associated with amnesia. Answer 3 and 4: Although propofol and alprazolam are associated with amnesia, neither of the medications are used for patients experiencing severe depression. Answer 5: Psychotherapy is not associated with amnesia.
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