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Did you know... Frequent mental distress (FMD) may interfere with major life activities, such as eating well, maintaining a household, working, or sustaining personal relationships. Hispanics had a higher prevalence of FMD (13.2%) compared to white, non-Hispanics (8.3%) or black, non-Hispanics (11.1%).
Source: CDC, Behavioral Risk Factor Surveillance System, 2006

ECT Mini-Fellowship

Emory University School of Medicine Department of Psychiatry presents ELECTROCONVULSIVE THERAPY MINI-FELLOWSHIP

The course is intended for psychiatrists interested in developing an ECT service and understanding the procedures for the administration of ECT. The course emphasizes practical aspects of ECT administration including the pre-ECT workup, consent process, administration of a treatment with “hands on” experience for the participants, management of ECT side effects and maintenance medication or maintenance ECT after an index course. The course will also provide reading material including an overview of the lecture material and the most recent APA guidelines for the administration of ECT.

OBJECTIVE

Understand the most recent evidenced based literature on the theoretical basis for the therapeutic efficacy of ECT and the procedures for the safe and effective administration of ECT. Review the policies and procedures required by Joint Commission and APA guidelines including necessary forms, pre-ECT work-up and post-ECT evaluation and follow-up. Practical experience in pre-ECT evaluations, observing ECT treatments, recovery and follow-up. The student will receive one-on-one training with an instructor.

COURSE STRUCTURE

Physicians in the Emory ECT Service administer approximately 180 treatments per month. This will allow course participants to be involved in approximately 20– 30 treatments during the three day course. The focus of the course is on the practical aspects of administering ECT with a strong emphasis on evidenced based literature supporting the practice of ECT.

FACULTY

William M. McDonald MD William M. McDonald MD is the JB Fuqua Professor of Psychiatry and Vice Chair for Education in the Department of Psychiatry and Behavoiral Sciences at Emory University.  Dr. McDonald is the Director of the ECT service, he has been administering ECT since 1993 when he came to Emory from Duke University.   Dr. McDonald is Chair of the American Psychiatric Association Committee on Electroconvulsive Therapy and Other Electromagnetic Therapies and is an active member of the Association of Convulsive Therapy.  Dr. McDonald has completed an NIMH funded study in maintenance ECT, is on the editorial board for the Journal of ECT and has been a lecturer and instructor in ECT seminars at both the APA and American Association of Geriatric Psychiatry.   Dr. McDonald is presently one of the authors on the APA’s upcoming revisions to the Recommendations for Treatment, Training, and Privileging for the Practice of Electroconvulsive Therapy.  Dr. McDonald was an investigator for the Neuronetics trial of transcranial magnetic stimulation (TMS) and was a principal investigator for the NIMH funded multicenter TMS trial involving Emory, University of Washington, Columbia and Medical University of South Carolina.  Dr. McDonald will be involved in the practical instruction of ECT as well as teaching of the course.

Adriana Hermida MD Adriana Hermida MD is the Director of the Geriatric Psychiatry Fellowship Program and former director of Electroconvulsive Therapy Service at Wesley Woods Geriatric Hospital. She supervises and is a consulting physician with the community & outpatient clinic, has been involved with research in transcranial magnetic stimulation and is the Emory University representative with the National Network of Depression Centers.

Patricio Riva Posse, MD Patricio Riva Posse MD was born in Buenos Aires, Argentina. He earned his Medical Doctor degree from the Universidad de Buenos Aires. He then completed a residency in Neurology at the "Instituto de Investigaciones Neurologicas- Dr. Raul Carrez - FLENI," was chief resident and worked as faculty for a year before moving to the US. He did his residency at Emory University and in his last year he was chief resident at Emory University Hospital. Since 2008, he has been involved in research in Deep Brain Stimulation for depression at Helen Mayberg's lab. He joined the faculty as Assistant Professor, and is currently an attending physician in the Medical Psychiatry Inpatient Unit at Emory University Hospital, an ECT provider and has a treatment resistant depression outpatient clinic. He is co-investigator in the protocol for subgenual cingulate DBS in depression.

Susan Henderson, FNP  received a Master's Degree as a Family Nurse Practitioner from Vanderbilt University in 1983. She has practiced in a variety of clinical settings since that time, including the Tennessee Department of Corrections, Vanderbilt University Student Health Service, public health outreach to homeless with mental illness in Nashville, alcohol and drug treatment with the VA, clinical research in infectious diseases, and retail and nonprofit primary care clinics. She has served as a clinical preceptor for FNP students throughout her career. She joined the Emory Department of Psychiatry in 2013, working initially on the inpatient Geriatric psychiatry units. She now coordinates the ECT Service. 

For more information and registration for our ECT Course, please click here or call Michele L. Miles at (404) 712-6941. 

Suggested Reading for Mini-Fellowship Participants

Electroconvulsive Therapy for Depression Click here
Medical Evaluation for Patients Undergoing Electroconvulsive Therapy Click here

Further Reading

Kellner CH, Knapp RG, Petrides G, Rummans TA, Husain MM, Rasmussen K, Mueller M, Bernstein HJ, O'Connor K, Smith G, Biggs M, Bailine SH, Malur C, Yim E, McClintock S, Sampson S, Fink M. Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE). Archives of Geriatric Psychiatry. 2006 Dec. 63(12):1337-44. Click Here (Full Article)

Christopher EJ. Electroconvulsive Therapy in the Medically Ill. Current Psychiatry Reports. 2003. 5(3): 225-230. Click Here (Full Article).

Holtzheimer PE, Kelley ME, Gross RE, Filkowski MM, Garlow SJ, Barrocas A, Wint D, Craighead MC, Kozarsky J, Chismar R, Moreines JL, Mewes K, Posse PR, Gutman DA, Mayberg HS. Subcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression. Archives of General Psychiatry. 2012 Feb. 69(2):150-8. Click Here (Full Article)

Holtzheimer PE, Mayberg HS. Stuck in a Rut: Rethinking Depression and Its Treatment. Trends in Neuroscience. 2010 Nov 9. 34(1):1-9. Click Here (Full Article)

Mayberg HS, Lozano AM, Voon V, McNeely HE, Seminowicz D, Hamani C, Schwalb JM, Kennedy SH. Deep brain stimulation for treatment-resistant depression. Neuron. 2005 Mar 3. 45(5):651-60. Click Here (Full Article).

Ujkaj M, Davidoff DA, Seiner SJ, Ellison JM, Harper DG, Forester BP. Safety and efficacy of electroconvulsive therapy for the treatment of agitation and aggression in patients with dementia. American Journal of Geriatric Psychiatry. 2012 Jan. 20(1):61-72. Click Here (Abstract Only)

Swaim JC, Mansour M, Wydo SM, Moore JL. A Retrospective Comparison of Anesthetic Agents in Electroconvulsive Therapy. The Journal of ECT. 2006 Dec. 22(4):243-6. Click Here (Abstract Only)

Datto C, Rai AK, Ilivicky HJ, Caroff SN. Augmentation of seizure induction in electroconvulsive therapy: a clinical reappraisal. The Journal of ECT. 2002 Sep;18(3):118-25. Click Here (Abstract Only)

Klapheke MM. Electroconvulsive Therapy Consulation:  An Update. Convulsive Therapy. 1997 Dec. 13(4):227-41.  Click Here (Abstract Only)

Prudic J, Olfson M, Marcus SC, Fuller RB, Sackeim HA. Effectiveness of Electroconvulsive Therapy in Community Settings. Biological Psychiatry. 2004 Feb 1. 55(3):301-12. Click Here (Abstract Only)

Greenberg RM, Kellner CH. Electroconvulsive Therapy:  A Selected Review. The American Journal of Geriatric Psychiatry. 2005 April. 13(4):268-281. Click Here (Abstract Only)

Petrides G, Braga RJ, Fink M, Mueller M, Knapp R, Husain M, Rummans T, Bailine S, Malur C, O'Connor K, Kellner C; CORE (Consortium for Research in ECT) Group. Seizure Threshold in a Large Sample: Implications for Stimulus Dosing Strategies in Bilateral Electroconvulsive Therapy: A Report From CORE. The Journal of ECT. 2009 Dec. 25(4):232-7. Click Here (Abstract Only)

 O'Reardon JP, Takieddine N, Datto CJ, Augoustides JG. Propofol for the management of emergence agitation after electroconvulsive therapy: review of a case series. The Journal of ECT. 2006 Dec. 22(4):247-52. Click Here (Abstract Only)

Chen ST. Remifentanil: a review of its use in electroconvulsive therapy. The Journal of ECT. 2011 Dec;27(4):323-7. Click Here (Abstract Only)

Fink M. The Practice of ECT: Recommendations for Treatment, Training and Privileging-Background. Convulsive Therapy. 1990 June. 6(2):82-84. Click Here (Abstract Only).

Kellner CH. Towards the Modal ECT Treatment. Journal of ECT. 2001 March. 17(1):1-2. Click Here (Abstract Only) 

 

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