Nervenheilkunde 2018; 37(09): 611-616
DOI: 10.1055/s-0038-1670572
Depression
Georg Thieme Verlag KG Stuttgart · New York

EKT bei depressiven Störungen

Indikation und DurchführungTreating depressive disorders with ECT
A. Sartorius
1   Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim / Universität Heidelberg, Mannheim
› Author Affiliations
Further Information

Publication History

eingegangen am: 20 June 2018

angenommen am: 03 July 2018

Publication Date:
29 August 2018 (online)

Zusammenfassung

Die Elektrokrampftherapie oder Elektrokonvulsionstherapie (EKT) gilt bei der Behandlung depressiver Störungen nicht nur als Routinetherapie, sondern bei schweren oder therapieresistenten oder wahnhaften Depressionen als Therapie der Wahl. Aufgrund bestehender Vorurteile und Stigmatisierungen ist die EKT in dieser Indikation in Deutschland im Vergleich zu anderen Industrieländern immer noch massiv unterrepräsentiert, obwohl sie mittlerweile ein modernes, sicheres, nebenwirkungsarmes und gut verträgliches Verfahren darstellt. In diesem Übersichtsartikel werden auch die Indikationen für schizodepressive Episoden, depressive Episoden mit führender stuporös-katatoner Symptomatik oder Depressionen mit vorbestehenden kognitiven Störungen oder begleitenden Parkinson-Syndromen diskutiert. Ebenso wird ein kurzer Überblick über die Durchführung einer EKT in Bezug auf Vorbereitung, Narkose und Stimulation, Überwachung, technische Parameter und Übergang in eine Erhaltungs-EKT gegeben.

Summary

Electroconvulsive therapy (ECT) can be recommended not only as a routine treatment for major depressive episodes, but also as a treatment of choice for severe or treatment resistant or psychotic depression. In Germany, ECT incidence is still massively lower compared with other western countries most probably due to prejudice and stigmas, while modern ECT is nowadays extremely safe with a low side effect profile. Additionally to severe or treatment resistant or psychotic depression, this review discusses the use of ECT for depression with leading stupor or catatonia, for schizodepressive episodes, for depressive episodes and preexisting cognitive impairments and for depressive episodes with concomitant Parkinson’s disease. Furthermore ECT technique in general is reviewed: Informed consent, prearrangements, anesthesia, stimulation itself, recovery, technical parameters and maintenance ECT are described and discussed.

 
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