Electroconvulsive Therapy / Edition 4

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Overview

In this extensive revision of his comprehensive book on ECT, Dr. Richard Abrams draws upon his broad clinical experience and intimate knowledge of the literature to provide a unique guide to ECT that stresses both the medical physiology of the procedure and its application to the high-risk patient. Now illustrated with many graphs and figures, the new text is over 100 pages longer than the first edition and contains more than 300 new references. The chapter on management of the high-risk patient has been greatly expanded, as has the section on the technique of ECT, which is now divided into two chapters: Theory and Praxis. Of particular importance to clinicians are Dr. Abrams' updated and exquisitely detailed stepwise guide to the practical administration of ECT, his new recommendations for maximizing the therapeutic yield of ECT, and his advice on optimal handling of its medico-legal aspects, based on his extensive experience as an expert witness. In this lucid work, Dr. Abrams traces the historical development of convulsive therapy and explores its physiological, ethical, political, biochemical, 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 of action. In full accordance with the American Psychiatric Association's new guidelines for the practice of ECT, this essential resource remains the primary reference and guide for those who prescribe, perform, or assist with ECT.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description: In this fourth edition of his benchmark textbook of electroconvulsive therapy (ECT), Dr. Abrams has updated each chapter with reviews of recent and relevant studies and has added a chapter on transcranial magnetic stimulation therapy (TMS). Dr. Abrams is an internationally renowned clinician-researcher and this book reflects his broad knowledge and wisdom regarding ECT.
Purpose: The purpose is to update information for the practicing clinician. According to Dr. Abrams, "Hundreds of new clinical studies culled from the more than 1,500 published since the third edition appeared have been analyzed in depth and incorporated throughout the book." Indeed, Dr. Abrams has made life easier for clinicians in helping to interpret this vast literature.
Audience: The audience includes practicing psychiatrists, academic and research psychiatrists interested in ECT. It should be mandatory reading for psychiatry residents. Attorneys, forensic psychiatrists, and neuropsychologists involved in legal issues regarding ECT would also find this book useful.
Features: The format of the book's 13 chapters is similar to that of the previous editions, with the addition of the chapter on TMS. Other topics covered include the history of ECT, efficacy, response prediction, physiology, management of the high-risk patient, issues regarding stimulus parameters, seizure induction and seizure quality, electrode placement, theory and practice of technique, cognitive functions, neurobiological correlates, patient attitudes, medicolegal issues and informed consent. The book ends with an exhaustive reference section and a helpful index.
Assessment: This book remains the gold standard for the analysis of the ECT literature and the practicalities of using ECT in clinical practice. I highly recommend it.
Michael J. Schrift
The third edition of this now-standard textbook covers nearly all the relevant issues of electroconvulsive therapy (ECT) and instructs the reader on the medical and technical facts needed to practice this treatment. The new edition, needed to convey the significant advances in the field, is a most valuable contribution to psychiatry and to the patients that need this treatment. The purpose is to improve psychiatrists' understanding and clinical management of patients receiving ECT. Dr. Abrams correctly believes that ""... the time is long past when clinicians giving ECT could just 'push the button' and hope for the best."" He is also correct that most residency training programs fail to instruct their trainees adequately, or at all, in this needed treatment. The intended audience is psychiatrists practicing ECT, particularly older practitioners who have not been able to ""keep up"" and for those recent graduates of psychiatry residency training programs who have not been adequately trained in this treatment modality or have not been trained at all. Topics covered include a historical perspective, review of efficacy studies, prediction of response, medical physiology, the high-risk patient, review of the literature regarding stimulus parameters, unilateral ECT, theory and practice of technical aspects, memory and cognitive functioning issues, neurochemical aspects, patient attitudes, and legal aspects. There is an up-to-date reference section and a useful index at the back of the book. This is an outstanding and comprehensive third edition of Dr. Abrams' textbook on ECT. Any clinician that is involved in the treatment of patients with mental illness should read this book. Allpsychiatry residents should be required to know the relevant topics that this book covers.
From The Critics
Enthusiastically defending the controversial use of electroconvulsive "therapy" (ECT), Abrams (psychiatry, Chicago Medical School), the director of a firm that manufactures ECT devices, reviews the practice and its literature. He briefly discusses the history of ECT and then outlines current practice and addresses the use of unilateral versus bitemporal ECT. He argues against the studies that find ECT to be a dangerous and unhelpful procedure. A final chapter considers ethical and legal issues, finding that doctors who refuse to subject patients to electroshock are behaving unethically and that malpractice suits are a relatively minor problem. Annotation c. Book News, Inc., Portland, OR

3 Stars from Doody
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Product Details

  • ISBN-13: 9780195148206
  • Publisher: Oxford University Press, USA
  • Publication date: 1/28/2002
  • Edition description: REV
  • Edition number: 4
  • Pages: 344
  • Product dimensions: 9.30 (w) x 6.10 (h) x 1.30 (d)

Meet the Author

Richard Abrams, M.D., is Professor of Psychiatry at The Chicago Medical School. He has conducted clinical and basic science research on ECT for more than a quarter of a century, during which time he has authored over 70 articles, books, and chapters on the subject. Dr. Abrams is also a widely-respected lecturer, whose many dozens of conferences and workshops on ECT have been enthusiastically received by thousands of practitioners attending them over the years. He has been a member of the Editorial Board of the journal Convulsive Therapy since its inception. Dr. Abrams also has numerous ECT-related patents to his credit, and is President of Somatics, Inc., a firm that manufactures and distributes the Thymatron ECT device.

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Table of Contents

1 History of Electroconvulsive Therapy 3
2 Efficacy of Electroconvulsive Therapy 17
3 Prediction of Response to Electroconvulsive Therapy 43
4 The Medical Physiology of Electroconvulsive Therapy 50
5 Electroconvulsive Therapy in the High-Risk Patient 72
6 The Electroconvulsive Therapy Stimulus, Seizure Induction, and Seizure Quality 101
7 Treatment Electrode Placement: Bitemporal, Unilateral, Bifrontal 130
8 Technique of Electroconvulsive Therapy: Theory 140
9 Technique of Electroconvulsive Therapy: Praxis 172
10 Memory and Cognitive Functioning After Electroconvulsive Therapy 176
11 Neurobiological Correlates and Mechanisms 202
12 Patients' Attitudes, Medicolegal Considerations, and Informed Consent 224
13 Transcranial Magnetic Stimulation Therapy (TMS) 239
References 253
Index 315
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