Notes

Recommended dose of electricity...for ease of terminology, "juice" is used to mean the voltage and length of current duration.

Factors that are known to increase the seizure threshold (meaning you have to give more juice to induce a seizure):

• unilateral
• male gender
• increased age
• treatment later in course (with each subsequent treatment, you have to increase the juice)
• high expected barbiturate anesthetic dosage
• received long half-life benzodiazepine the previous day

Additionally, Abrams recommends a dose of 4 to 8 seconds. And his machine will do it

Impedance is basically the resistance the current encounters. It is mostly from the skull, which is a thick bone through which the current must pass.

Other factors that cause impedance are placing the electrodes too close together and skin that has not been properly prepared (oily, too many dead cells, etc.)

Abrams very subtly suggests things throughout his book that directly lead one into a special feature of his Thymatron[TM]. The Audible EEG[TM] is a case in point: (bold is my emphasis)

"Because the EEG directly measures the brain's electrical activity, it remains the standard against which other techniques must be measured. Two methods are presently incorporated in ECT instruments for amplifying and presenting unprocessed EEG activity during ECT. One uses a chart-drive and pen writer to record the EEG signal on paper; the resulting record is then read by the clinician as it is generated...The second method provides an auditory representation of the EEG signal in the form of a tone that fluctuates with the frequency of the seizure activity and becomes constant when the seizure ends. (This method) has been used successfully to detect prolonged seizures requiring termination with benzodiazepines."

Now, based on that reading, which machine would *you* rather have? The old fashioned one with a pen, and which requires someone to read it as it happens, or the new and improved Audible EEG[TM] which emits a tone?

The Thymatron[TM] of course.

The one thing that Abrams doesn't do, is to plug the Thymatron[TM] by name. He simply suggests throughout the book features that are available only with his machine. Since he doesn't own up to owning Somatics, it's a very clever way of boosting sales. Hey, didn't subliminal messages go out with the 60s?

Maybe not.

What? I thought you guys keep saying there isn't any memory loss. And this is the new and improved ECT. Brief-pulse square wave current was developed in 1938, folks.

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