ECT, The Thymatron and Dr. Richard Abrams

The following is an actual advertisement for the ThymatronTM, an ECT device from Somatics, Inc. The company is owned by Dr. Richard Abrams, author of Electroconvulsive Therapy, considered to be the definitive ECT text.

Is it a conflict of interest for one of the top "experts" on ECT to write the definitive text, setting standards of practice in ECT, while making money on the ECT machine that fits his perfect criteria? The publisher of his book, Oxford University Press, was shocked to hear that he owned Somatics. He says he didn't tell them because he didn't think of it. He says it's no big deal.

In the text of the ad below you will find links to additional information on that terminology. The information comes from the 1992 edition of Abrams' book.

The Thymatron^TM : Description and Specifications

* A single dial sets the treatment stimulus: you can just set it to your patient's age to automatically deliver the recommended dose of electricity.

* A light-emitting impedance meter instantly tells you if the treatment electrodes are properly and safely applied at any time, even when the patient is awake.

* The patented Audible EEGTM monitors the seizure without the need for EEG expertise or paper. Demonstrated to be highly reliable and valid, the Audible EEGTM is built in to every ThymatronTM .

* You can treat as quickly as you need to with the ThymatronTM. There are never any annoying waits for warmup or stimulus override.

* An optional plug-in EEG recorder provides a permanent paper record of the seizure. This instrument can also record the EKG, with full limb and chest lead capability.

* A remote treatment foot switch is available to enable the single operator to administer unilateral ECT safely and conveniently.

* Readily portable, the ThymatronTM in its optional fitted case weighs only 15 lbs.

* The brief pulse square wave stimulus delivers all voltage over the seizure threshold, producing significantly less memory loss and EEG disturbance than the obsolete sine wave stimulus, without any loss of therapeutic benefit.

* Four seconds of pulsed stimulation can be given with the ThymatronTM, providing the extra energy required to treat the difficult cases.

* The ThymatronTM safeguards against accidental electrical discharge with a hinged flip-up cover over the treatment button, and audible and visible stumulus (sic) indicators.

* The Underwriters Laboratories listed construction protects against excessive electrical current, isolating the patient from the electrical line through relays, fuses and a power-limiting transformer.

* The pulsewidth is preset at 1 millisecond, the optimal for ECT.

* Stimulus settings are precision fine-tuned by equal click stop increments; the constant current ensures that each setting corresponds to a specific electrical charge.

* In an illustrated treatment manual, Drs. Richard Abrams and Conrad Swartz take you step by step through a fully documented description of how to give ECT with the Thymatron TM . A full discussion includes indications, precautions, contraindications, and the management of side-effects and complications.

* In an inservice demonstration color videotape, Dr. Richard Abrams illustrates exactly how to use the Thymatron TM and its accessories.

* An illustrated service manual is included which explicitly guides your maintenance department through all the recommended testing procedures.

FOR MORE INFORMATION OR A FREE LOAN OF DR. ABRAMS' DEMONSTRATION VIDEOTAPE, PHONE OR WRITE TO US

SOMATICS, INC.
910 Sherwood Drive Unit 18
Lake Bluff, IL 60044
Interstate toll-free 800-642-6761

THERE'S ONE Thymatron TM BECAUSE THERE'S ONE BEST WAY TO GIVE ECT

Note 1

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

So, based on this, you simply turn the dial up to increase the juice. Did you notice that the numbers listed on the dial range from 10 to 100? Does that mean that quite a lot of 10-year-olds and 100-year-olds are getting ECT?

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

Note 2

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.)

Note 3

This is a special feature. Abrams claims that EEG monitoring is very important, especially in unilateral ECT.

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 penwriter 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.

Buy Thymatron ^TM Buy Thymatron^TM Buy Thymatron^TM

And in case you'd rather have the old fashioned pen and paper EEG, he's got that too! And an added value...the EKG. (see next feature!)

Note 4

Is he suggesting housecalls? Drive-thru ECT? McECT? Every family should have one!

Note 5

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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