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A technical note from the Ministry of Health on the current policy changes in mental health, alcohol and other drugs aimed at increasing the supply of electroconvulsive treatment, known as the name of "electroshock", was received with criticism regarding a possible regression of the Bolsonaro diet in relation to
Electroconvulsive therapy has been regulated since 2002 by the CFM (Federal Council of Medicine), but many still badociate this treatment with the methods of torture and cruelty of the past
However, the devices have evolved over the past decades and care is taken to ensure that the patient does not experience pain or discomfort either. However, stigma and prejudice persist around this technique
Therapy is part of what are called biological treatments in psychiatry. , whose effects depend neither on drugs nor pharmacological results, but neurophysiological changes
The modification of brain chemistry for the release of certain neurotransmitters is also the principle of action of several psychiatric remedies, but this action is systemic, that is, the active substance of the drug circulates throughout the body, causing side effects
Several national and international studies have shown that it was An effective tool in the treatment of serious psychiatric disorders such as schizophrenia, deep depression and bipolar disorder, especially those who did not respond.
In some situations, such as psychotic states and severe mental disorders in the elderly and pregnant women, electroconvulsive therapy may even be the first choice of treatment and is often safer than constant use In case of depression during or during badfeeding, for example, s the chemicals can be absorbed by the baby through the placenta or bad milk
The treatment has been studied for years in universities such as USP and Unifesp and has been adopted by several hospitals and private psychiatric clinics. Many court decisions require even health plans to pay for it. In depression, electroconvulsive therapy is usually indicated when drugs do not produce more results, when there are excessive side effects or even when there is an imminent risk to the patient as a suicide attempt.
The procedure is not indicated for all psychiatric conditions and, on the recommendation of the medical specialist, it can only be carried out with the consent of the patient or the person in charge of the family.
The patient receives general anesthesia and the electrodes induce an electrical current in the brain that causes the seizure, altering the levels of neurotransmitters and neuromodulators, such as serotonin.
Electroconvulsive therapy also causes side effects, including nausea and memory loss. Proponents of the technique, however, say that the problem is temporary and that permanent memory loss is very rare.
For psychiatrist Leonardo Peroni de Jesus, the story was not fair with electroconvulsive therapy (ECT), considered by him as an important tool in psychiatric treatment.
"It is well known that totalitarian regimes have resorted not only to the ECT, but also to psychiatry to apply inhumane torture to their political and ideological flaws." The soap operas and movies have also not tolerated the ECT, "
There is today a new frontier of studies that aim to stimulate the brain against depression and the Morbid obesity and drug addiction, for example, with less invasive devices than those used in electroconvulsive therapy, which can reduce the risks and costs.
In a note, Cremesp (São Paulo Regional Medical Council) ) said that the use of electroconvulsive therapy, Always surrounded by ideological and non-scientific stigma and opposition, presents scientific support for your work.
The organization stated that the development of the technical standard, led by the Ministry of Health, relied on the contribution of specialists who recognized the clinical importance of treatment
Patients whose electroshock treatment is indicated by should undergo anamnesis and extensive examinations for cardiological evaluation.
"The panel has an obligation to broaden the debate and to constantly review the results achieved by science and current practice in this field of medicine, so as not to deprive precisely the patients most in need of the best treatments, "said Cremesp [19659002] New technologies use low electrical charges or localized action painless magnetic pulses. They include transcranial stimulation devices positioned on the scalp and forehead and can use electrical or magnetic energy and electrode implants in the brain (deep brain stimulation).
In 2012, transcranial magnetic stimulation was approved by CFM. and is no longer an experimental procedure in the country for three therapeutic indications: the treatment of uni and bipolar depressions, auditory hallucinations in schizophrenia and planning for neurosurgery.
In the United States, the FDA approved the stimulation in 2008.
The main risks badociated with brain stimulation are transient, such as headaches, neck pain and tingling.
In the case of deep brain stimulation, we add surgical risks, such as anesthesia and infections.
Jan-Hendrik Heinrichs of the Julich Institute of Neuroscience and Medicine in Germany, an article in the International Journal of Law and Psychiatry, warns of the risk of overestimating the possibilities and benefits of technological manipulation in relation to more humanistic approaches to medicine
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