Max Fink, Professor Emeritus of Psychiatry and Neurology, was the invited Guest Editor for a three-part series on ECT in the January 2011 issue of the Canadian Journal of Psychiatry.
To fulfill the assignment Dr. Fink commissioned an essay on effective clinical practices by the Belgian psychiatrist Pascal Sienaert, MD, the author of the Belgian-Dutch ECT guidelines. In his article Dr. Sienaert describes methods to assure effective treatments, the need for continuation treatments, and considerations in anesthetics.
Dr. Fink also invited Tom Bolwig, MD, of Copenhagen to review the mechanisms of ECT. Dr. Bolwig is actively studying the role of neurogenesis and is best known for his demonstration that seizures affect the blood-brain-barrier, an essential element in changes induced by seizures. Dr. Bolwig describes the competing neuroendocrine hypothesis developed by Dr. Fink and his students Richard Abrams and Michael Taylor, and the generalized seizure theory.
In his editorial Dr. Fink argues that despite its ups and downs, and despite its unjustified stigmatization, ECT continues to be the safest and most effective treatment for specific forms of depression, catatonia, and mania. An understanding of the mechanisms by which the induction of seizures resolves psychiatric symptoms is an unresolved challenge to modern neuroscience. "ECT offers the best opportunities to understand the abnormal brain processes that underlie major psychiatric disorders,” Dr. Fink says in the editorial.
Dr. Fink was also the guest editor for the December 2010 number of the Journal of ECT in which ten essays present the latest experiences in relieving Catatonia.
