| (a) The major indications for the therapeutic use of ECT are major mood disorders. ECT may be considered for some other disorders, with appropriate consideration of the risk/benefit ratio. (b) The major contraindications to the therapeutic use of ECT are as follows: (1) absolute space-occupying intracranial pathology; (2) relative, requiring clinical consideration: (A) cardiovascular disease, including arrhythmias, myocardial disease, or coronary artery disease; (B) diseases which render a patient likely to suffer hemorrhage, including peptic ulcer, subdural hematoma, and aortic aneurysm; (C) degenerative diseases of the central nervous system; (D) glaucoma although it is recognized that intraocular pressure is not increased by ECT, and is, in fact, reduced during the seizure period, medications used adjunctively to the treatment may result in increased intraocular pressure. For patients with glaucoma, consideration should be given to pretreatment with physostigmine; (E) severe orthopedic disability. |
