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Principles and Practice of Electroconvulsive Therapy

Keith G. Rasmussen, M.D.

  • ISBN 978-1-61537-241-6
  • Item #37241

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Even with the rise of newer neuropsychiatric brain stimulation methods, electroconvulsive therapy (ECT) remains a widely used treatment for severe mental illness—and perhaps the most effective for serious mental illness. Optimal treatment requires that psychiatrists be skilled in diagnosis and familiar with the techniques of treatment.

That's where Principles and Practice of Electroconvulsive Therapy comes in. With its up-to-date, comprehensive coverage of all aspects of ECT, this is an unrivaled resource for psychiatrists, whether in practice or still in training, striving for maximum treatment efficacy.

The book begins with an overview of what ECT is and how it is carried out, followed by a brief history of the therapy, from its earliest applications to its use in modern times. The guide follows the typical course of treatment, discussing the following:

  • Understanding the indications for ECT and selecting patients who might benefit from this therapy—whether they suffer from depression, mania, schizophrenia, or catatonia
  • Educating patients and their families on ECT and obtaining patient consent
  • Conducting a pretreatment medical evaluation and understanding the role of anesthesia
  • Managing an individual ECT treatment, including choosing the electrical stimulus dose and parameter combination, delivering the electrical stimulus, assisting with recovery problems, etc.
  • Overseeing the course of treatments, particularly for practitioners not personally conducting the treatments
  • Managing patients after a course of treatments and preventing relapse
  • Assessing and managing the memory side effects of ECT

The final chapter examines other neuropsychiatric stimulation therapies in relation to ECT and explains how to choose among them. All chapters conclude with easily referenced key points that summarize the most salient ideas. Readers seeking to further educate themselves on ECT will also benefit from the exhaustive reference list.

Though particularly useful for psychiatrists and psychiatric residents, Principles and Practice of Electroconvulsive Therapy, with its straightforward style, is a ready resource for any mental health or medical professionals interested in ECT.


  • Chapter 1. Introduction to ECT
  • Chapter 2. Patient Selection for ECT
  • Chapter 3. Patient Education and Informed Consent for ECT
  • Chapter 4. The Pre-ECT Medical Workup
  • Chapter 5. Anesthesia for ECT
  • Chapter 6. ECT Technique, Part I: Managing the Individual Treatment
  • Chapter 7. ECT Technique, Part II: Managing the Course of Treatments
  • Chapter 8. Preventing Relapse after ECT: Maintenance ECT and Pharmacotherapy
  • Chapter 9. Cognitive Effects of ECT
  • Chapter 10. ECT Versus Other Neuropsychiatric Treatments
  • References
  • Index

About the Authors

Keith G. Rasmussen, M.D., is Professor in the Department of Psychiatry and Psychology at the Mayo Clinic in Rochester, Minnesota.

I have long preferred single- to multi-authored medical texts, especially on limited topics such as ECT, and it has been 16 years since publication of the most recent single-authored textbook on the subject. Dr. Keith Rasmussen is eminently suited to write such a text as he has been performing ECT and publishing research articles on the subject for almost 30 years—the last time I looked he had over 100 such articles to his credit, as well as being the 2008 recipient of the Journal of ECT Annual Investigator's Award. In addition to his long-term appointment at Mayo Clinic, Dr. Rasmussen has been a collaborator in the Consortium for Research in ECT (CORE) since its inception, having co-authored many key articles with that most important of ECT research groups.—Richard Abrams, M.D., Professor of Neuropsychiatry retired, University of Health Sciences/The Chicago Medical School

Dr. Rasmussen's Principles and Practice of Electroconvulsive Therapy is a welcome addition to the most recent volumes on the topic of ECT. This book's stated purpose is for preparing for the practice of ECT.While it may be helpful to medical students, interns, and experienced providers alike, it is particularly well suited for the physician preparing to add ECT to their practice.

Accordingly, the book is extremely practical, with useful, easy to understand tables and figures for each of the main chapter topics, and key point summarized at the end of each chapter. Chapters are logically divided into the various steps of preparing a patient to receive ECT, such as patient selection, medical work-up, role of anesthesia, management of concurrent medication during ECT, and the actual choice and delivery of the ECT itself. The discussion of patient capacity to consent to ECT is particularly well-done. The final chapter closes with a well-balanced discussion of the relative roles of ECT vs TMS, MST, tDCS, VNS, etc., and with extensive references. I recommend it.—W. Vaughn McCall, M.D., M.S., Dept Psychiatry, MCG

This outstanding book offers a very comprehensive discussion of ECT practice. As part of my fellowship training in ECT, I navigated many resources to learn about it, and I came to find this book both comprehensive and competent. The author collects up-to-date helpful information on ECT practice. This book helped me select the right candidates for the procedure and learn about who needs to be excluded, among other clinical pearls. The author highlights essential aspects of anesthesia applicable to ECT as well. This book includes a summary of the findings from the OPT-ECT study that calls to attention possible neurobiological effects from pharmacotherapy during ECT. The author presents an exhaustive review of amnesia related to ECT and refutes the idea that ECT wipes out memory or causes brain damage. The author leaves the door open for technological improvements in modalities like FEAST, while reflecting on observed limitations of others, like VNS or MST. This is an excellent guide to becoming an ECT clinician and I highly recommend it. Both seasoned ECT clinicians and trainees would benefit their patients by knowing and understanding the information in this superb book.—Alan Georges, M.D., Doody's Book Review

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