S7: Updates on Electroconvulsive Therapy practice and research

Abstract

Electroconvulsive Therapy (ECT) has evolved into a highly safe, effective, and well tolerated treatment for several severe psychiatric conditions and has become a necessary tool in the armamentarium of modern psychiatry. In this symposium we will review current state of the art clinical practices in Electroconvulsive Therapy (ECT) and new data on research.More specifically Dr. Charles Kellner will review the elements of optimal patient selection/preparation in the ECT consultation and review clinical decision-making during a course of ECT (including electrode placement, stimulus dosing and other technical procedural details.)Dr Raphael Braga will review the evidence for the use of ECT as an augmentation to antipsychotic medications strategy for the treatment of patients with schizophrenia who are resistant to medications, including clozapine.Dr. Brent Forester will discuss the rationale and evidence base for the safety and efficacy of ECT for the treatment of Agitation in Dementia. Agitation is the most common neuropsychiatric symptom of dementia, accounts for about 12% of the total health and social care costs (approximately $31billion/year). It is implicated in a vicious cycle of negative events including deterioration of family and professional relationships, increased risk of death, and increased caregiver burden, which is a significant predictor for institutionalization or death of patients with dementia. His presentation will highlight the existing evidence base and method of ECT delivery to target symptoms of severe agitation, and review an ongoing multi-site NIA funded clinical trial of ECT for severe agitation in dementia.Dr Søren Dinesen Østergaard will discuss the suicide risk in patients receiving ECT which, despite the well-established anti-suicidal effect of ECT, remains high due to the severity of their underlying illness. He will present data quantifying and identifying risk factors for suicide among patients receiving ECT using data from nationwide Danish registers on 11,780 patients.Dr. Georgios Petrides is the organizer and will moderate this symposium