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by Richard Abrams
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Medicine & Health Sciences
  • Author:
    Richard Abrams
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  • Publisher:
    Oxford University Press; 3 edition (January 15, 1997)
  • Pages:
    382 pages
  • Subcategory:
    Medicine & Health Sciences
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    1403 kb
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Electroconvulsive Therapy.

Electroconvulsive Therapy.

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Table of Contents Memory and Cognitive Functioning After Electroconvulsive Therapy 11. Neurobioogical Correlates and Mechanisms 12. Patients' Attitudes, Medicolegal Considerations, and Informed Consent 13. Transcranial Magnetic Stimulation Therapy (TMS). This excellent text is a complete synopsis of the current status of ECT and an important volume to be aware of. Books for People with Print Disabilities. Internet Archive Books.

Typically, 70 to 120 volts are applied externally to the patient's head resulting in approximately 800 milliamperes of direct current passed through the brain, for 100 milliseconds to 6 seconds duration, either from temple to temple (bilateral ECT) or from front to back of one side of the head (unilateral ECT).

29 results for richard abrams. Electroconvulsive Therapy by Richard Abrams (English) Hardcover Book Free Shippi.

In this third edition of his indispensable textbook on ECT, Dr. Richard Abrams draws upon more than 30 years of clinical and research experience to provide a unique guide to the theory and practice of ECT that stresses both its medical physiology and its application to the high-risk patient. Important new material has been added on the nature of the electrical stimulus and the relation of stimulus parameters and dosage to the physiology of the cerebral neuron and the quality of the treatment. Extensive detail is now provided on the latest approaches to the complex subject of EEG monitoring, with specific instructions on assessing the therapeutic impact of an induced seizure. The relative roles of unilateral and bilateral ECT are re-examined in light of this new approach, leading to updated recommendations for maximizing the therapeutic yield of ECT in the treatment-resistant patient. The section on management of cardiovascular risks and complications--especially in the geriatric patient--has been thoroughly updated to emphasize the role of beta-blockers. The widespread use of caffeine for lengthening seizures is critically reassessed, and new recommendations have been added concerning the anesthetic agent propofol and the pre-anesthetic atropine. Techniques of stimulus titration are now extensively covered, with new information and recommendations regarding the utility as well as potential risks of this procedure. Clinical entities recently appearing in the literature, such as myocardial stunning and nonconvulsive status epilepticus, are critically evaluated, as is the role of isoflurane anesthesia as a potential replacement for ECT. Of particular importance to clinicians are Dr. Abrams updated and exquisitely detailed step-wise guide to the practical administration of ECT, and his advice on the optimal handling of its medico-legal aspects, based on his extensive experience as an expert witness. In this lucid and comprehensive work, Dr. Abrams traces the historical development of convulsive therapy and explores its physiological, ethical, biochemical, political, neuroanatomical, and clinical aspects. He covers such diverse topics as the prediction of treatment response, the results of sham ECT studies, patients attitudes towards the treatment, neuropsychological and cognitive effects, the nature of the ECT stimulus, medico-legal considerations, and theories concerning its mechanism in action. In full accordance with the American Psychiatric Associations guidelines for the practice of ECT, this essential resource remains the primary reference and guide for those who prescribe, perform, or assist with ECT.

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.
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!
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.
this is a medical book, providing the informations necessary for the good practice of ECT. there is no room for ideology in this type of text. all a doctor can expect.

Helbert Campos, psychiatrist, Brazil