Electroconvulsive Therapy (ECT) 

Electroconvulsive therapy (ECT) is a medical treatment most commonly used in patients with severe depression, bipolar disorder and psychotic illnesses such as schizophrenia, that has not responded to other treatments. 

ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia. This results in a brief, controlled seizure that affects neurons and chemicals in the brain. The person does not feel anything due to the anesthetic.

People are asleep during the procedure and wake up 5-10 minutes after it has finished. They are able to resume normal activity in about an hour.

Most people have 4 to 6 treatments before major improvement is seen. This is followed by additional treatments and in some cases “maintenance ECT” on a less frequent basis, such as once a month. ECT is typically administered by a team of trained medical professionals that includes a psychiatrist, an anesthesiologist, and a nurse or physician assistant. 

Indications For ECT:

Extensive research & Clinical evidence has established that ECT is highly effective for the relief of major depression. ECT will produce substantial improvement in approximately 80 % of patients. 

It is also used for other severe mental illnesses, such as bipolar disorder and schizophrenia. 

ECT is sometimes used in treating individuals with catatonia, a condition in which a person can become increasingly agitated and unresponsive. A person with catatonia can seriously injure themselves or develop severe dehydration from not eating or drinking. 

ECT is typically used when other treatments, including medications and psychotherapy, haven’t worked. ECT is also used for people who require a rapid treatment response because of the severity of their condition, such as being at risk for suicide or refusing food up to starving themselves. 

Effectiveness of ECT

ECT’s effectiveness in treating severe mental illnesses is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health, and similar organizations in Canada, Great Britain and many other countries. 

Although ECT can be very effective for many individuals with serious mental illness, it is not a cure. To prevent a return of the illness, most people treated with ECT need to continue with some type of maintenance treatment. This typically means psychotherapy and/or medication or, in some circumstances, ongoing ECT treatments. 

What are the Risks and Benefits of ECT?

Like any medical procedure, ECT is has some risks. ECT treatment has been associated with short-term memory affection. Some people have trouble remembering events that occurred in the weeks before the treatment or earlier. In most cases, memory problems improve within a couple of months. Some patients may experience longer lasting problems, including permanent gaps in memory. 

The risks of general anesthesia, which is needed for ECT, are similar to the risks when anesthesia is used for other procedures such as minor surgeries. The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours. 

These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders. For some patients, the risks of ECT may be less than those of ongoing treatment with medications. ECT can work more quickly than medications. It can be especially useful if a patient is suicidal, is not responding to medications or cannot tolerate the side effects of medication. 

Other Brain Stimulation Treatments