Electroconvulsive Therapy: Update and Comprehensive Review
Resource Availability
This course material was originally created by SMI Adviser, now rebranded as SMI CalAdviser. The content in this course material is still current and relevant, yet, please be aware that some external resources and links may no longer be active or available. 
Overview

Since its inception over 80 years ago, electroconvulsive therapy (ECT) has been the gold standard of treatment for catatonia, psychotic depression, and treatment resistant depression, as well as a non-pharmacologic option for other psychiatric illnesses and syndromes. This presentation will be an evidence-based review of all aspects of ECT, including the history, indications, efficacy, side effects, procedural details and advances, maintenance treatment, myths surrounding treatment, and possible mechanisms of actions. By the end of this webinar, you should understand when referral for ECT is appropriate and be up to date on the recent advances in this life-saving treatment.   

Format 

Recorded webinar, non-interactive, self-paced distance learning activity with post-test.  

This presentation was recorded on June 25, 2021. 

Learning Objectives  

Be readily able to identify a patient who is appropriate for ECT treatment.    

Describe different techniques to decrease the cognitive side effects of ECT.    

Summarize options for maintaining ECT response.   

Outline 

  • Introduction & Logistics  
  • What is ECT? 
  • A Brief History of ECT 
  • Why ECT is Still Used & Who Gets It 
  • Indications and Efficacy (Supported by Case Examples) 
  • The ECT Procedure Itself 
  • Cognitive Effects & Memory 
  • Advancements: Ultrabrief Pulse ECT 
  • Basic Treatment Algorithm (McLean Hospital) 
  • Maintenance Treatment 
  • Addressing Myths and Mechanisms 
  • Support and Resources 
  • Conclusions 

Target Audience 

Psychiatrist, Physician (Non-Psychiatric), Nurse, Nurse Practitioner, Psychologist, Peer Specialist,  

Instruction Level 

Intermediate  

Estimated Time to Complete  

Estimated Duration: 1.0 hour 
Program Start Date: July 30, 2025  
Program End Date: July 30, 2028

Ongoing Interdisciplinary Discussion Board  

After completing the course, engage with colleagues in the mental health field through the Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.  

How to Earn Credit 

After completing the evaluation, participants will have the opportunity to claim their hours of participation and download the appropriate certificate. Physicians may obtain an official CME certificate, other healthcare professionals may receive a CE certificate (as applicable), and all other attendees may generate a certificate of participation. Each certificate will reflect the event date and total hours earned. 

Continuing Education Credit 

In support of improving patient care, American Psychiatric Association (APA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.  

Physicians   

The APA designates this live event for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   

Nurses/Nurse Practitioners   

The American Psychiatric Association (APA) designates this activity for 1.00 Nursing contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.   

 

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited Medical Education. Any individuals in a position to control the content of a CME activity - including faculty, planners, reviewers, or others - are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.  

Faculty  

  • John B. Roseman, MD, has interests spanning a broad range, with expertise in bioinformatics, medical education, and neurotherapeutics, particularly electroconvulsive therapy (ECT). As the associate director of the ECT Service at McLean Hospital, Dr. Roseman shares oversight of the busiest ECT service in the country (more than 10,000 ECT treatments per year).  He is also McLean’s Director of Medical Student Education for Harvard Medical School, helping train medical students at the hospital. As the psychiatry clinical content lead for Partners eCare since 2013, he has helped lead the integration of the Epic electronic health record into inpatient and outpatient psychiatry across Partners, with an ongoing focus on McLean’s optimization of the Epic system. In clinical practice, Dr. Roseman focuses on ECT treatment of severe depression, bipolar disorder, psychotic disorders, and agitation in dementia, while also maintaining a psychodynamically oriented outpatient practice. Dr. Roseman reports no financial relationships with commercial interests. 

Program Planners 

  • Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.   
  • Tristan Gorrindo, MD, American Psychiatric Association. Reports no financial relationships with commercial interests.   
  • Donna Rolin, PhD, APRN, University of Texas at Austin. Reports no financial relationships with commercial interests. 

Reviewers   

  • Donna Rolin, PhD, APRN, University of Texas at Austin. Reports no financial relationships with commercial interests. (Reviewed on 6/4/2023)  

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 

Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 

Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 

Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 

Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity |  

Contact support@smicaladviser.org for technical assistance

Summary
Availability:
On-Demand
Expires on Jul 30, 2028
Credit Offered:
1 CME Credit
1 Psychology CE Credit
1 COP Credit
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