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The electroconvulsive therapy (ECT) service at University Hospital has a
long tradition of excellence. Founded by Dr. Max Fink, who is internationally
recognized for his work on ECT and who is an Emeritus Professor in the Department
of Psychiatry and Behavioral Sciences, the ECT service is currently directed by
Dr. Laura Fochtmann. Dr. Fochtmann has served as a member of the American Psychiatric
Association Committee on ECT and Other Electromagnetic Therapies and contributed
to the 2001 APA Task Force Report, The Practice Of Electroconvulsive Therapy:
Recommendations for Treatment, Training and Privileging.
ECT is one of the most effective psychiatric treatments for treating mood
disorders and catatonia, and may also be indicated for patients with psychotic
illnesses whose symptoms have not responded to other treatment approaches.
Thus, the ECT service plays an important role in the clinical and teaching
missions of the Department.
The ECT service offers treatment to individuals on an inpatient basis.
Most patients receive a series of treatments two to three times each week
over a two- to three-week period. Under some circumstances, in patients who
have responded well to ECT, additional treatments may be given periodically
on an outpatient basis to prevent return of symptoms.
ECT treatments are administered by a team of specially trained psychiatrists,
psychiatric nurses and anesthesiologists in a newly renovated, state-of-the-art
suite which includes separate areas for pre-treatment preparation, treatment
and recovery. This level of expertise and monitoring ability allows the ECT
service to provide treatment to individuals who need ECT but who also have
medical problems that may limit treatment in other settings. Members of the
ECT treatment team are involved in all aspects of the patient's care including
the initial discussion of whether ECT may be helpful, assessment of the
patient's medications and physical condition, discussions of the potential
benefits and side effects of treatment, obtaining of informed consent, the
administration of anesthesia and controlled electrical stimulation with each
treatment, monitoring of the patient's physical and psychiatric condition as
the treatment proceeds, and developing a plan for treatment after the ECT
course is completed. At all stages of the evaluation and treatment process,
patients and families are encouraged to ask questions and actively collaborate
in the planning of care.
Psychiatric residents are also integral members of the ECT treatment team
and learn about ECT under the direct supervision of psychiatric faculty. As
part of their PGY-1 and/or PGY-2 years, residents spend from 1 to 2 months on
the inpatient ECT service as part of their inpatient psychiatry experience. During
this time, residents have the opportunity to provide longitudinal care for multiple
patients receiving ECT. As a result, residents learn about the clinical evaluation
and management of patients receiving ECT including clinical indications, benefits
and side effects of treatment, aspects of informed consent, and technical aspects
of ECT administration including monitoring, electrode placement, stimulus dosing,
and anesthetic medications. As part of their PGY-4 year, some residents elect to
return to the ECT service for additional experience and didactic instruction on ECT.
Faculty:
Laura J. Fochtmann, M.D., Director, ECT Service
Andrew J. Francis, Ph.D., M.D.
ECT Nurse Coordinator:
Colleen Coan, RN
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