The electroconvulsive therapy (ECT) service at Wake Forest University Baptist Medical Center is recognized internationally as a center of excellence for the treatment of severe and treatment resistant mental illness. ECT is one of the most effective psychiatric treatments for treating mood disorders (major depression and bipolar disorder), improving symptoms and quality of life. ECT may also be helpful for patients with psychotic illnesses whose symptoms have not responded to other treatment approaches.
The ECT service offers treatment to individuals in both the inpatient and outpatient (day hospital) setting. Most patients receive a series of treatments two to three times each week over a two- to three-week period. Under some circumstances, in patients who have responded well to ECT, additional treatments may be given periodically on an outpatient basis to prevent return of symptoms.
ECT treatments are administered by a team of specially trained psychiatrists, psychiatric nurses and anesthesiologists in a state-of-the-art facility which is integrated with the hospital’s accredited areas for pre-treatment preparation, treatment and recovery. This level of expertise and monitoring ability allows the ECT service to provide treatment to individuals who need ECT but who also have medical problems that may limit treatment in other settings. The ECT treatment team is involved in all aspects of the patient's care including the initial discussion of whether ECT may be helpful, assessment of the patient's medications and physical condition, discussions of the potential benefits and side effects of treatment, obtaining of informed consent, the administration of anesthesia and controlled electrical stimulation with each treatment, monitoring of the patient's physical and psychiatric condition as the treatment proceeds, and developing a plan for treatment after the ECT course is completed. At all stages of the evaluation and treatment process, patients and families are encouraged to ask questions and actively collaborate in the planning of care.
R.E.S.P.E.C.T.
The motto for the treatment team is that all patients are deserving of R.E.S.P.E.C.T., which stands for ECT treatment that is Repectful, Effective, Safe, Personalized, Ethical, Competent, and Timely.
Psychiatric residents are also integral members of the ECT treatment team and learn about ECT under the direct supervision of psychiatric faculty. As part of their PGY-2 and/or PGY-3 years, residents spend 3 months on the ECT service. During this time, residents have the opportunity to provide longitudinal care for multiple patients receiving ECT. As a result, residents learn about the clinical evaluation and management of patients receiving ECT including clinical indications, benefits and side effects of treatment, aspects of informed consent, and technical aspects of ECT administration including monitoring, electrode placement, stimulus dosing, and anesthetic medications.