Posted by ed_uk on June 26, 2005, at 11:08:42
In reply to Is ECT really superior in the States to the UK, posted by Denise1966 on June 26, 2005, at 9:59:42
>I think Ed_uk mentioned they were different.
I did?
You do need to make sure that the ECT you're having is 'high quality'. Apparantly, some centres don't even monitor the EEG - they use the useless 'cuff' method instead. You need to make sure that the clinic you go to is accredited by the Royal College of Psychiatrists.
http://www.priory.com/psych/ectolectas.htm
http://www.rcpsych.ac.uk/cru/ECTASstandardsDec04.pdf
Personally, if I was to need ECT, I'd only have it done at a clinic rated 'excellent' ie. all criteria fulfilled, type 1, 2 and 3. Only 'type 3' clinics monitor the 2 channel EEG!
http://www.rcpsych.ac.uk/cru/ECTAS.htm
'Its (the UK Royal College of Psychiatrists) most recent report in 1999 rated only a third of clinics in England and Wales as good. It also found that junior doctors were often left unsupervised and many ECT machines were outdated.
Dr Benbow admitted that ECT practice had not always been found to meet RCPsych guidelines.
"At present you should have a consultant in charge of the ECT clinic overseeing the technicians and junior doctors administering the treatment to ensure it is up to scratch," she said, adding: "However, audits have found that some consultants spend very little time in these units, so if you accredit them that might not have much impact upon standards."
The college had considered adopting the US regulatory system of accrediting ECT practitioners, revealed Dr Benbow, but its preferred option was accrediting the clinics instead. This would bring poorly performing units under its scrutiny and make them liable to face sanctions up to and including closure.'
Btw, you're right about maintenance ECT in the UK. NICE (National Institute for Clinical Excellence) has recommended that maintenance ECT should not be used in the UK. Nevertheless, doctors or not obliged to follow these guidelines if they don't want to. I think it would be fair to say that most pdocs would refuse to give you maintenance ECT though.
'A leading Scottish psychiatrist has pledged to flout government guidelines and continue to give depressed patients regular electric shock treatment for periods of several years.
Dr Donny Lyons, consultant in electroconvulsive therapy (ECT) at Leverndale Hospital in Glasgow, has warned that he will ignore new guidelines, that the procedure should only be given in short courses, whenever he thinks it would be against a patient's interest.
He said: "If I have a choice between following these guidelines and doing what I think is best for my patients, then I will do the latter. I am not going to tell my patients they cannot have this treatment because Nice [the National Institute of Clinical Excellence] advises against it. My duty to patients will take precedence. I have no difficulty deciding not to follow the guidelines because I do not think they are correct. I would be very unhappy if my ability to help people is impeded by guidelines that don't make any sense."'
~Ed
poster:ed_uk
thread:519163
URL: http://www.dr-bob.org/babble/20050622/msgs/519209.html