Posted by SLS on May 13, 2000, at 15:30:01
In reply to Re: ECT literature search, posted by Elizabeth on May 13, 2000, at 13:48:49
> I'd be kind of worried about exposing the fetus to the general anasthetics and neuromuscular blocking agents used in ECT, personally! Not sure this is justified, it's just my gut reaction.With me, they used Valium as the anesthetic and atropine as the neuromuscular blocking agent. What are your thoughts as to how these drugs may hurt the fetus?
Is atropine considered a muscle-relaxant?
How does Valium exert its muscle-relaxant effects?> > If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints?
> A person should not be committed for any of those things. AFAIK, a particular diagnosis is *never* a sufficient reason to commit someone involuntarily (in any of the 50 States, anyway).
Perhaps I should have been more specific. I didn't mean that a person is to be involuntarily committed for having been diagnosed with one of these afflictions, but rather that they be in such a condition as to "require" it. I am pretty sure that there are statutes in most states prescribing detailed definitions of these conditions and allowing for commitment. I think the notion of "being a danger to themselves or others" is in there somewhere.
Do you feel that commitment is ever in the best interests of the afflicted person?
> > Non-response to antidepressants is a prognosticator of poor response to ECT.
> It's true. There's a selection bias at work, in that people who have ECT are usually those who've failed multiple antidepressants. Also, sometimes it's used as a last resort for conditions for which it's not necessarily indicated, such as severe nonmelancholic depression; this further affects the apparent success rate.
There certainly is a bias. In many situations, as in those you have mentioned, the recognition of this association is moot. You just have to roll the dice. However, the bias may be the de facto realization of a biological condition. This observation has heuristic value. Perhaps it will be helpful in figuring out what's going on.
One thing worth considering is that for most of the cases in which ECT is employed, the patient is not treatment-naive. Prior exposure to antidepressants may reduce the likelihood that they will be responsive to ECT.
By the way, its nice to see you again. I hope school has gone well and that the beast has been kept at bay.
I know I always have to ask you these questions, but what does "AFAIK" stand for? I wish I had a dictionary.
Be well.
Sincerely,
Scott
poster:SLS
thread:32651
URL: http://www.dr-bob.org/babble/20000508/msgs/33380.html