http://exhibits.library.stonybrook.edu/mfp/files/original/84db3111e5609e3a16dce2777a1866cf.pdf f609d02d0570f215ac17053a41f738ad PDF Text Text December 21, 1988 ml—m'vr ,- flaw” w». www—r—r—,~ GretaKoinig, M.D. Psychiatrische Universitéitsklinik Allgemeines Krankenhaus der Stadt Wien Wilhringer Gurtel 18-20 1090 VIENNA AUSTRIA Dear Greta, What a pleasant surprise to receive your informative letter and greetings. have regularly received news from Vienna from our young Ph.D. scientist (who seems to be doing very well in his laboratory work, and his social life). We Protocol: Dr. Gangadhar has been a regular contributor to CONVULSIVE THERAPY and he had informed me that he was planning to study in Vienna. I read the proposal and it is consistent with our present knowledge and experience. There are a few points that you may wish to consider. A study focussed on a defined course of 6 ECT argues that about 1/3 or of the subjects will be inadequately treated at that measurement. Whatever more benefits ECT may provide, may yet develop with more treatment. it may be better science to design the study so that that the ratings of depression reach an arbitrary (though low) value as the time at which the prolactin measures are re-examined. Prolactin release is influenced by electrode placement, amount of energy (threshold or supra-threshold), type of current (sinusoidal or brief—pulse), and sex and age of the subject. One problem with the Siemens Konvulsator is that it delivers variable amounts of energy. Some attention should be paid to these variables in the design of the study. While the study is of temporal interest, a more illuminating study of dopaminergic phenemona in ECT might be one of patients with parkinson disease and depression. Suggest that Dr. Gangadhar read CONVULSIVE THERAPY g: 321327 (Fochtmann) and 3: 189—191 (Fink). Hypothesis: As for the other questions, I enclose a copy of a report which I have just sent to the journal Neuropsychopharmacology, and’which is under editorial review. It is the latest version of the neuroendocrine hypothesis of ECT. . "W wwwt‘ �Dr. Greta Koinig December 21, 1988 Training: We do not have a formal ECT training program for our psychiatric residents. in the first year, they receive lectures on affective disorders and the treatments available; about 3 hours are devoted to ECT. In their second year, while on the in-patient service, they spend two months on the 'ECT Team', managing every case referred for ECT. On average,’they manage about 8-12 cases. ECT is also discussed in the weekly attending case rounds. Finally, selected residents may do research in ECT duing their elective period (fourth year) for periods up to six months. We average one resident each year. in addition, we have organized a formal hands-on' training in ECT. A description is enclosed. The next course is sceduled for the week of March 6, 1989. lPAAE: The details of the lPAAE are enclosed. (The society is changing its name to The Association for Convulsive Therapy (ACTH. ECT DATABASE: Citation searches for tapics in ECT are available to subscribers and contributors to CONVULSIVE THERAPY, by request addressed to my office. There is no formal citation list that is made up periodically; each issue of CONVULSIVE THERAPY contains the citations included in the database in the previous quarter. There are numerous ways to reach me. Using the University BITNET system, my address'is MFINKQSBCCMAIL.BITNET. For FAX, my temporary number is 516- 862 8604 (although this will change in about a month). My home number is 516-862 6651. i am delighted that there is a resurgence in interest in ECT in Vienna. i have been gratified by the continuing acceptance of ECT and CONVULSIVE THERAPY; its portrayal as a reasonable treatment; the greater investment in training and improved facilities; and the greater attendance and interest in ECT at conferences and meetings. The main thrust today is no longer the acceptance of ECT, nor its indications, nor the technical details of currents and electrode placements, but in its mode of action. Hopefully, this interest will improve our understanding of both the treatment and the pathOphysiology of affective disorders. 1989. i trust these responses are helpful. 'iy best wishes for a happy and healthy Sincerley yours, Max Fink, M.D. Professor of Psychiatry � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. 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