Swartz Conrad M, Nelson Alexander I
Dr. Swartz is from the Southern Illinois University, Springfield, Illinois.
Psychiatry (Edgmont). 2005 Jul;2(7):37-43.
Expertise in medicating depression requires experience with all types of antidepressants, including several medications within each type. Likewise, electroconvulsive therapy (ECT) proficiency includes experience with each of the modern electrode placements, of which there are four. Besides traditional bilateral and right unilateral placements, ECT electrode placement includes bifrontal and left anterior right temporal (LART) placements. In comparing antidepressant drugs, clinical trials have proven few differences of statistical significance, and useful proven differences are still more unusual. Analogously, few differences have been proven between ECT electrode placements, and many reported differences can be accounted for by large differences in electrical stimulus dosage. Still, the absence of proven differences does not show that there are no useful variations. This paper reviews the meaningful differences that are generally appreciated from clinical experience and biomedical principles for ECT electrode placement as well as antidepressant drugs.
治疗抑郁症的专业技能需要具备使用各类抗抑郁药的经验，包括每类药物中的多种药物。同样，电休克疗法（ECT）的熟练掌握包括对每种现代电极放置方式的经验，共有四种。除了传统的双侧和右侧单侧放置外，ECT电极放置还包括双额和左前右颞（LART）放置。在比较抗抑郁药物时，临床试验已证明几乎没有统计学上的显著差异，而已证实的有用差异仍然更为罕见。类似地，ECT电极放置之间几乎没有被证明存在差异，许多报告的差异可以用电刺激剂量的巨大差异来解释。然而，缺乏已证实的差异并不表明没有有用的变化。本文回顾了从临床经验和生物医学原理中普遍认识到的ECT电极放置以及抗抑郁药物的有意义差异。
