Substance Abuse and Abuse Q 55
The nurse is discussing electroconvulsive therapy (ECT) with a client who asks how long it will be before she feels better. The nurse explains that the beneficial effects of ECT usually occur within:
A. One week
B. Three weeks
C. Four weeks
D. Six weeks
Correct Answer: A. One (1) week
Beneficial effects of ECT usually are evident after the first several treatments. Since treatments are administered at intervals of 48 hours, these effects are apparent after one week of therapy. Beneficial effects of ECT therapy are usually seen before three weeks. It takes three to four weeks for tricyclic antidepressants to take effect. ECT is indicated in patients with treatment-resistant depression or severe major depression that impairs activities of daily living. The definition of treatment-resistant depression is depression that is unresponsive to multiple antidepressant medication trials.
Option B: ECT is a relatively safe and low-risk procedure that is helpful in the treatment of depression, suicidality, severe psychosis, food refusal secondary to depression, and catatonia. It requires interprofessional care coordination among anesthesiologists, psychiatrists, and nurses. Most patients require several sessions to see a durable effect.
Option C: ECT is indicated in patients with treatment-resistant depression or severe major depression that impairs activities of daily living. The definition of treatment-resistant depression is depression that is unresponsive to multiple antidepressant medication trials. There are also suggestions for ECT as a treatment for suicidality, severe psychosis, food refusal secondary to depression, and catatonia. Bipolar depressive and manic patients can also receive treatment with ECT. ECT may have a safer profile than antidepressants or antipsychotics in debilitated, elderly, pregnant and breastfeeding patients.
Option D: Today ECT is now frequently used to treat a variety of mental health disorders besides depression. The procedure is relatively safe, and does work. However, the delivery of ECT requires an interprofessional team that includes a nurse, anesthesiologist, psychiatrist and neurologist. The benefits of ECT are seen after several sessions and the results are durable. The key is to educate the patient and family about ECT because the procedure has been associated with many false and illogical beliefs.