Irving Reti MBBS
Professor of Psychiatry and Behavioral Sciences
imreti@jhmi.edu
Telephone Number: 410-955-1484
Fax Number: 410-614-8128
The Johns Hopkins Hospital
Psychiatry
600 North Wolfe Street
Baltimore, MD 21205
Room: Meyer 7-120
Lab Page
Telephone Number: 410-955-1484
Fax Number: 410-614-8128
The Johns Hopkins Hospital
Psychiatry
600 North Wolfe Street
Baltimore, MD 21205
Room: Meyer 7-120
Lab Page
Behavioral Neuroscience and its Clinical Applications
Electroconvulsive therapy (ECT) is far and away the most effective treatment for severe depression, however little is known about how it works. Learning more about how ECT works is important for several reasons. It might help us optimize ECT technique that maximizes efficacy and minimizes memory loss associated with the treatment. Understanding the ECT mechanism of action could help guide the development of other potentially efficacious treatments for depression and other conditions, both pharmacologic and somatic. Such treatments ideally would not trigger the cognitive side effects of ECT nor require anesthesia. Lastly, if we knew how ECT worked, it could help shed light on the pathophysiology of conditions treated with ECT.
ECT for suppressing intractable self-injurious behavior
About a quarter of individuals with autism spectrum disorder display repetitive self-injurious behavior (SIB) including head banging and self-directed biting and punching. In some patients, these behaviors are extreme and unresponsive to traditional pharmacological and behavioral therapies with devastating consequences for the patients and their families. We have found ECT can produce life-changing results with a greater than 90% reduction in frequency of SIB in patients with the most severe forms of self-injury. However, these patients typically require frequent maintenance ECT (mECT) to sustain the improvement gained during the acute ECT course. Such mECT regimes can be as frequent as one treatment every 5 days. However, ECT is associated with cognitive side effects and the long-term consequences of mECT started as early as childhood in some cases are unknown. Accordingly, we are interested in learning more about how ECT works in these patients and developing alternate forms of brain stimulation which could potentially suppress SIB without the side effects associated with ECT.
About a quarter of individuals with autism spectrum disorder display repetitive self-injurious behavior (SIB) including head banging and self-directed biting and punching. In some patients, these behaviors are extreme and unresponsive to traditional pharmacological and behavioral therapies with devastating consequences for the patients and their families. We have found ECT can produce life-changing results with a greater than 90% reduction in frequency of SIB in patients with the most severe forms of self-injury. However, these patients typically require frequent maintenance ECT (mECT) to sustain the improvement gained during the acute ECT course. Such mECT regimes can be as frequent as one treatment every 5 days. However, ECT is associated with cognitive side effects and the long-term consequences of mECT started as early as childhood in some cases are unknown. Accordingly, we are interested in learning more about how ECT works in these patients and developing alternate forms of brain stimulation which could potentially suppress SIB without the side effects associated with ECT.