Electroconvulsive Therapy: A Guide for Professionals and Their Patients »

Max Fink, MD, is Professor of Psychiatry and Neurology Emeritus at State University of New York at Stony Brook

Electroconvulsive therapy (ECT), despite its controversial history, may well represent the only viable treatment for severe psychiatric illness in those for whom medication is not an option. In Electronconvulsive Therapy, Dr. Max Fink draws on over 50 years of clinical experience to describe this safe, painless, and often life-saving treatment.

Extensively revised and restructured since its original publication a decade ago, the book provides readers with a detailed explanation of the ECT procedure, helping them to better understand and prepare for treatment. Discussions of the mechanisms of actions have been updated and sections have been added on the use of ECT in pediatric populations and to treat movement disorders such as Parkinsons. Case studies of ECT patients illustrate its often dramatic success in relieving depression, mania, catatonia, and psychosis. Clarifying the many misconceptions surrounding the treatment, Dr. Fink reveals how anesthesia and muscle relaxation techniques reduce discomfort and risks to levels lower than those associated with psychiatric drugs. He then provides a historical perspective of the treatment, from the discovery of ECT and its widespread use beginning in the 1930s, to the 1950s when it was replaced by psychotropic drugs, to its revival in the last 30 years as a viable psychiatric treatment. Dr. Fink concludes with a straightforward discussion of the ethical issues surrounding ECT use, and on its similarities to and differences from other modern brain stimulation techniques.

The classic text on the subject, written by a renowned researcher and physician, Electroconvulsive Therapy is an excellent resource for patients, their families, and mental health professionals.

Doody Review Services

Reviewer:Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description:It is most unfortunate that electroconvulsive therapy (ECT) remains an underutilized and frequently neglected lifesaving treatment modality. ECT is the most effective treatment in psychiatry for melancholia and catatonic states, relieving these illnesses more quickly, safely, and fully than psychotropic medication or any other intervention. Over his career, Max Fink, MD, has been an unwavering, stalwart advocate for the effectiveness of electroconvulsive therapy in general and its use over other treatments for serious mental Illness. This is Dr. Fink's latest addition to his extensive body of work and is representative of his gifts as a teacher and a clinician. It is a welcome addition to the psychiatric literature.
Purpose:The purpose is to provide answers to common questions asked by patients, their families, and professionals such as: "Is this treatment still used? Is it safe? Is there a risk of brain damage? Will there be memory loss?" Dr. Fink hopes that "this book will help you understand and appreciate its (ECT) potential to heal the severely psychiatrically ill." Indeed, Dr. Fink has produced a very readable and informative guide.
Audience:Those faced with the decision of whether to use ECT are the intended audience, which includes patients, their families, and clinicians -- primary care physicians, nurses, and psychiatrists. It should be required reading for residents (trainees) in psychiatry residency training programs.
Features:The book covers what ECT is, the treatment from the patient's perspective, the treatment technique, side effects, and the use of ECT in various disorders, including mood disorders, movement disorders, psychosis, pregnancy, and pediatric neuropsychiatric disorders, how it might work, the history of ECT, whether brain stimulation is an alternative to ECT, and the ethics of ECT. The best parts of the book are the patient vignettes that provide sketches of real life psychiatric situations. The useful appendixes include a list of diagnoses for which ECT is considered to be effective and ineffective, a sample informed consent document, and common medication names and uses. The bibliography contains relevant and important citations on recent research on ECT.
Assessment:This new edition is an instructive and readable guide to ECT for clinicians, patients, and families faced with severe, unrelenting, and disabling psychopathology.

1 What Is Electroconvulsive Therapy? 3

2 The Patient's Experience 10

3 The Treatment Technique 25

4 Side Effects and Memory Issues 34

5 Depressive Mood Disorders 43

6 Manic Mood Disorders 57

7 Movement Disorders 67

8 Other Uses: Psychosis, Pregnancy, and Status Epilepticus 75

9 Pediatric ECT 85

10 How Does ECT Work? 94

11 How Did Convulsive Therapy Originate? 103

12 Is Brain Stimulation an Alternative to ECT? 111

13 Is ECT Practice Ethical? 115

Appendices 121

Notes 129

Bibliography 139

Index 153