Proposals for the mechanism of action of convulsive therapy: a synthesis.
The convulsive therapies have been powerful additions to somatic treatment in psychiatry and have enjoyed widespread application for the benefit of many. A number of theories have been advanced in efforts to account for therapeutic efficacy but none has been comprehensive. These theories can be distinguished by whether they posit a central therapeutic role for stimulation, inhibition, psychological effects, or mixed processes induced by treatment. After critically reviewing extant theories, we propose a model for the effects of the convulsive therapies: Convulsive therapy is essentially nonspecific; "nonphysiological" depolarizations are distinctly important for the restoration of aberrant intravesicular transmitter ratios with resultant therapeusis. We present this model as a working hypothesis that may contribute to the guidance of research in the mechanism of action of convulsive treatment and offer several testable hypotheses in this regard.
King
B H
BH
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine 90024.
Liston
E H
EH
D001921:Brain / Q000503:physiopathology; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D001523:Mental Disorders / Q000503:physiopathology / Q000628:therapy*; D018377:Neurotransmitter Agents / Q000502:physiology
D018377:Neurotransmitter Agents