Advances in Electroconvulsive Therapy for Psychiatric Disorders

We reviewed the history of electroconvulsive therapy (ECT) around the world and in Japan. Although the practice of ECT began in Japan at around the same time as the discovery of ECT in the world, improvements in anesthetics and ECT devices in Japan have not progressed at a similar pace in comparison with that of the world. Recently, a brief pulse device was approved for use in Japan and ECT practice guidelines were established. ECT has been recently reevaluated and an ECT network has been extended in Japan. Specifically, we offer here a history of ECT and clinical and biological research findings for ECT from the Kure Medical Center. In 2013, our center conducted nearly 500 ECT sessions with approximately 40 individuals who had mood disorders, schizophrenia or Parkinson disease. Research on ECT has shown that several factors are important in recovery. For example, a strategy that includes a dosage of stimulation energy or reduction of anesthetic might be effective for ECT treatment. Mood stabilizers such as lithium may be effective in preventing relapse after ECT, not only in mood disorders, but also for schizophrenia. In addition, cerebral blood flow evaluation using near-infrared spectroscopy and blood markers such as matrix metalloproteinases may be related to diagnosis and the course of ECT treatment.