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Electroconvulsive Therapy [Hardcover]

Richard Abrams (Author)
4.0 out of 5 stars  See all reviews (4 customer reviews)

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Book Description

0195148207 978-0195148206 July 15, 2002 4
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.

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Editorial Reviews

Review


"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


About the Author

Richard Abrams is at The Chicago Medical School.

Product Details

  • Hardcover: 344 pages
  • Publisher: Oxford University Press, USA; 4 edition (July 15, 2002)
  • Language: English
  • ISBN-10: 0195148207
  • ISBN-13: 978-0195148206
  • Product Dimensions: 9.3 x 6.4 x 1.3 inches
  • Shipping Weight: 1.4 pounds (View shipping rates and policies)
  • Average Customer Review: 4.0 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Best Sellers Rank: #1,650,897 in Books (See Top 100 in Books)

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19 of 26 people found the following review helpful:
3.0 out of 5 stars ECT from an expert's view, April 16, 2001
By 
Electroshock therapy, or ECT as it is called these days, dates to early in the 20th century and has a reputation for being, well, bad for patients. Abrams' book is apparently the definitive textbook for physicians/ psychiatrists/ psychologists looking to learn the techniques and trappings. The third edition was published in 1997 and is still current. Primarily, the text describes the use of ECT in elderly patients with histories of psychosis or depression previously unresponsive to chemical treatment. Critics have questioned the motive behind this text, suggesting it is purely financial and to encourage a practice in which he has personal economic interest. (Abrams has also led seminars on the subject, and rumor has it he controls a portion of the company that manufactures ECT equipment.)

Concerning the content of the book: Abrams knows what he's talking about. He is the acknowledged expert in ECT, and if anyone is qualified to write a book about it, it is he. However, the text does not touch heavily enough (in my opinion) on the downside of ECT - the potential for very serious side effects and complications, including permanent memory loss, organic brain dysfunction, and even death. The clinical information is pertinent, and the format is understandable and logical. I didn't see the earlier editions of this text, but the chapters noted as being new do indeed contain relevant information.

For any professional interested in ECT in practice or even in theory, this is a valuable resource, but it should be balanced with a dissenting voice. Unfortunately, research on this issue tends to be lopsided and incomplete, with experts like Abrams claming very high success rates, and former patients giving anecdotal evidence of severe and long-lasting aftereffects.

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13 of 20 people found the following review helpful:
5.0 out of 5 stars No anecdotal information should serve as evidence., March 14, 2002
I... that Dr. Abrams is an expert in ECT and his book is well written. However I would argue that the critique on not being "balanced with dissenting voice" has no scientific/logic base.

Our society is so poisened by political demands (correctness) that the scientific truth is often submerged by mass desire. When we evaluate a medical procedure, we must base our argument on scientific data. I have read literature in this field extensively, and I have not yet found any solid research data showed that ECT imposed danger of "permanent memory loss, organic brain dysfunction, and even death". To me, case reports are no data, anecdotal opinion is no data. For only the sake of discussion, please consider this: if we did ECT on 1000 patients, and 2 of them dead, 3 of them got brain injury, and the families of these 5 patients went to the press. All we may hear now is that ECT killed or damaged people. However, the hidden truth might be: without ECT 10% of the 1000 patients would have killed themselves, 20% would have health damage out of malnushiment due to financial difficulty (e.g., loss job), alcohol and substance, other medical conditions that were worsened by depression, and 5% of them were killed by chemical treatment, and etc. ECT may have dramatically improved the life quality of 70% of this 1000 patients. We will never know the truth if we stop at the anecdotal information provided by the 5 cases.

Anecdotal, according to American Heritage Dictionary, means: based on personal observation, case study reports, or random investigations rather than systematic scientific evaluation. I am not a zealous advocator of ECT, but I trust only scientific evidence. If anyone would tell me ECT caused brain damage, please show me the scientific evidence. Don't tell me you or your uncle or your sister was damaged by ECT. Don't tell me how many psychiatrists admitted the "downside" of ECT. Show me the well designed research, show me the well controlled data.

Truth is never "balanced dissenting voice". Truth can only be found through scientific research. Three hundred years ago, the balanced dissenting voice said the earth is the center of the universe. The man argued against the balanced dissenting voice was killed. However, the truth was, as it was 1 million years ago, as it is today, as it will be 1 million years later, that the globe is not the center of the universe. How do we know that? Through scientific research!

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3 of 5 people found the following review helpful:
3.0 out of 5 stars Very technically written, but informative., April 1, 2005
This review is from: Electroconvulsive Therapy (Hardcover)
The book is very informative, but can be quite technical for the non-medical person. Also, with the FDA approval of vagus nerve stimulation for chronic depression, I would recommend a great book about this medical breakthrough procedure: "Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression". It is written by a patient for patients. Apparently this new therapy has none of the side effects of ECT.
Depression is still dismal, so anything that offers hope other than ECT sounds good to me.
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Inside This Book (learn more)
First Sentence:
The traditional litany on the history of the medical uses of electricity, beginning with the Roman use of electric fish to treat headaches (Harms, 1956; Sandford, 1966; Brandon, 1981), is simply beside the point; electroconvulsive therapy (ECT) evolved solely as a result of Ladislaus von Meduna's original investigations on the effects of camphor-induced convulsions in schizophrenic patients. Read the first page
Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
treatment electrode placement, subconvulsive stimuli, stimulus titration, stimulus train duration, electrode placement effects, postictal suppression, motor seizure duration, right unilateral placement, seizure quality, seizure end point, subconvulsive stimulation, anticonvulsant hypothesis, magnetic stimulation therapy, stimulus charge, electrical dosage, stimulus dose, seizure length, unilateral electroconvulsive therapy, seizure generalization, electrical dose, postictal delirium, seizure termination, motor threshold, anticholinergic premedication, bolus push
Key Phrases - Capitalized Phrases (CAPs): (learn more)
American Psychiatric Association, United States, Electroconuulsiue Therapy, Mini-Mental State, Wechsler Memory Scale, Max Fink, National Institutes of Health, Royal College of Psychiatrists, Seizure Phase, Hillside Hospital, Inspection of Table, Siemens Konvulsator, United Kingdom
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