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The Psychiatric Body
Published in Roger Cooter, John Pickstone, Medicine in the Twentieth Century, 2020
Two new practices in the therapeutic arsenal of this period have been retained, in modified forms, up to the present. First, in the later 1930s Ugo Cerletti, a professor of neuropathology and psychiatry in Rome, and Lucio Bini introduced electroshock, or, as it was later relabelled, electroconvulsive therapy. Enlightenment Mesmerists and Victorian nerve doctors had applied low doses of static electricity to the skin surface. ECT, in contrast, involved the direct mechanical stimulation of the brain with electrodes placed on the temples in order to produce momentary, therapeutic convulsions. For reasons that were — and remain unclear, shocking the brain often provides relief from major depression. The one serious side effect, doctors discovered, was selective, short-term memory loss. In the late 1940s and 1950s, ECT clinics for daily administrations of electroshock therapy to large numbers of patients were common features of British, American, and Canadian mental hospitals. In the 1970s, the psychiatric profession, responding to popular, scientific, and governmental concerns, established guidelines for the use of ECT.
The Electroshock Model, Neuronal Networks, and Antiepileptic Drugs
Published in Carl L. Faingold, Gerhard H. Fromm, Drugs for Control of Epilepsy:, 2019
A variety of factors have been shown to influence the response to electroshock. Most of these have been summarized previously by Woodbury,36 Swinyard,4a and Millichap37 and the reader is referred to these reviews for more detail. It appears that these studies have examined the effect of the various factors on seizure susceptibility, but it is likely that seizure severity is also affected. Again, we will restrict our review to studies that have been carried out in rats or mice subjected to ac-EST or MES. The factors that have been shown to alter the response to these types of electroshock include: age, diet, body temperature, blood glucose, carbon dioxide, acid-base balance, degree of hydration, a large number of endocrine factors (hormones), stress, and repeated seizures. In the interest of space the effect that these factors have on electroshock seizures is summarized in Table 1. Drug treatments and other factors that modify neurotransmitter systems can also alter the response to electroshock, but these will not be considered here because a comprehensive discussion can be found in a recent review.27 On the other hand, electroshock seizures can also alter neurotransmitter systems which may, in turn, alter the response to subsequent tests depending on how long the effect persists. Since this information is important for interpretation of the electroshock literature and has not been discussed in connection with electroshock models of epilepsy, it will be discussed in the next section.
The Efficacy and Safety of MMECT – Seizure Parameters
Published in Barry M. Maletzky, C. Conrad Carter, James L. Fling, Multiple-Monitored Electroconvulsive Therapy, 2019
The standard method of administering ECT is generally to schedule the treatment three times a week (Monday, Wednesday, and Friday), a frequency determined by administrative and practical, rather than scientific and clinical, concerns. Pragmatic issues of cost and convenience are important, however, and, with a lack of data to support other schedules, this regimen persists.9 Most clinical texts now recommend that conventional ECT be administered two to three times weekly, with daily administrations for those severely or suicidally ill. Attempts to accelerate the pace of remission are usually associated with regressive electroshock therapy (REST),167,168 a procedure in which multiple treatments were given daily for several days to several weeks so as to produce a disorganized state in which a patient was totally dependent upon others, hence “regressed.” Once thought helpful for schizophrenia, this form of ECT is rarely practiced today.
Eugenic Technologies Are Developed in Eugenic Eras: Why We Must Include Historical Circumstances in Socio-Political Perspectives for Neuroethics
Published in AJOB Neuroscience, 2022
I will now discuss a case study of another neurotechnological development, that of electroshock therapy, first developed by Ugo Cerletti and Lucio Bini in interwar Fascist Italy. Regardless of any technological improvements made since then, the invention of this technique must nevertheless be understood against the backdrop of Fascism and authoritarian nationalism in Italy. At that time, Italian nationalism was purposefully intertwined with technology development, and scientific achievement was specifically hailed as Italy’s potential means to strengthen its position in the world and to make up for slow progress in industrialization (Russo 1986). Some unsavory components of the early research are typically ignored; for example, Cerletti found inspiration by watching (and trying out) electric shock as a slaughterhouse stun technique (Berrios 1997; Cerletti 1950). Electroshock was later tested via unconsented human research on vulnerable individuals. Cerletti himself described the first human subject:
Comparison of preseptal and pretarsal onabotulinum toxin an injection in patients with hemifacial spasm
Published in International Journal of Neuroscience, 2021
Ayşen Tuğba Canbasoğlu Yılmaz, Murat Yılmaz, Mehmet Fevzi Öztekin
Nihon Kohden MEB-9200 (Nihon Kohden Co., Tokyo, Japan) electromyography device was used for EMG recordings. Supraorbital nerve was stimulated by bipolar electroshock with bipolar superficial stimulating electrodes. Recordings from both sides of orbicularis ocular muscles were obtained using superficial electrodes. During supraorbital nerve stimulation, right-angle electrical shocks with a duration of 0.1–0.2 ms were used. The intensity of the electrical current used was below the pain threshold. The intensity of the electrical current was adjusted to ensure that all responses were complete, clear and maximal. Indifferent electrode was placed on zygomatic area. For supraorbital nerve stimulation, consecutive electric shocks of 1 frequency per second were used. Electrical stimulation of the peripheral facial nerve was also performed using superficial electrodes. The active electrode was placed laterally on the lower eyelid. Indifferent electrode was attached to the back of the nose.
A World of Indifference/Un Monde D’Indifférence: Canadian Women’s Experiences of Psychiatric Hospitalization/Expériences Canadiennes d’hospitalization psychiatrique au Canada
Published in Issues in Mental Health Nursing, 2020
Cheryl van Daalen-Smith, Simon Adam, Fatima Hassim, Francine Santerre
Few would disagree that for people experiencing significant emotional distress–as some of the participants were pre-hospitalization–who then find themselves in a place predicated on alleviating that very distress, that the care practices should be beneficial and yield no harm. Unfortunately (and tragically), this was not the case for these 12 women. All of the participants’ experience of psychiatric hospitalization left them in a worse state than before they were hospitalized. They described care practices and experiences that were oppressive, punitive and immediately or eventually harmful. Being isolated, ignored, and dismissed eroded their already fragile self-esteem. Being medicated, often with powerful cocktails of psychotropic drugs, impinged upon their ability to think, feel, interact, or process things. All of the women explained that the impact of the drugs had the most deleterious effects. For those who experienced electroshock as a part of their psychiatric hospitalization, all articulated an irreparable decline in their memory and cognitive capacity. The women lost credibility, all lost the capacity to work due to physical and cognitive debilitation, and each experienced eventual poverty, in which they describe as directly linked to their post-hospitalization incapacitation. Their experience was anything but affirming or empowering: it was a series of oppressive practices that brought physical, cognitive, spiritual, financial, and existential harm. The women left their psychiatric hospitalization(s) ashamed, physically and cognitively debilitated, and diminished (See Table 3).