This article is more than 5 years old. Information may no longer be current.
What is electroconvulsive therapy?
Electroconvulsive therapy is a treatment option for psychological disorders, such as major depressive disorder that does not respond to treatment, major depression with psychosis, and bipolar disorder. It has been used since the 1940s and has improved significantly since it was first developed. Despite negative portrayal in popular culture and movies, it is considered a very safe and highly effective treatment for patients with severe psychological disorders. In patients with severe major depression, electroconvulsive therapy has been found to result in significant improvements in 80% of patients.
Electroconvulsive therapy (ECT) treatments are usually done two-to-three times per week, and usually about six to 12 treatments are needed. The procedure is done under general anesthesia and is painless to the patient. Patients are also given a muscle relaxant to prevent unsafe movement during the procedure.
The treatment consists of a brief electric current delivered to the head to cause a controlled seizure in the brain. The seizure, which typically lasts about 40 seconds, is usually triggered on only one side of the brain. While scientists do not yet fully understand how ECT works, it is thought to stimulate neurons in the brain and change the brain’s chemistry. The results of ECT are usually seen much more quickly than those achieved through psychiatric medications.
Memory loss is one of the main side effects of ECT treatment. However, this side effect has improved over the years through the use of lower doses of electricity. Often the memory loss applies to the weeks prior to the treatment and is resolved within a few months. However, in some cases the memory loss is ongoing. Some patients report having difficulty forming new memories after the procedure.
Other possible side effects of ECT treatment may include the following:
- Short-term confusion;
- Headaches or muscle pains (these effects usually go away shortly after treatment);
- Low or high blood pressure;
- Long-term memory loss (not common);
- Nausea; and
- Fatigue.
ECT is not a recommended therapy for all patients with depression. However, for certain patients whose depression or psychotic symptoms have not responded to other treatments, it is considered highly effective and safe.
Some patients who are considered particularly good candidates for ECT are as follows:
- Patients with depression who are also having delusions or hallucinations.
- Pregnant women who are severely depressed.
- Patients who are suicidal.
- Those who are not able to take antidepressant drugs.
- Those who have not benefitted from antidepressant drugs.
After undergoing a successful ECT treatment, a patient may take antidepressants if appropriate, or may periodically have additional ECT treatments to decrease the risk of future episodes of depression.
ECT is a serious procedure, and although it is highly effective and generally safe, it is not for all patients with depression. While it does carry some risks, these risks are usually tolerable considering the often far greater risks of untreated major depression.
Reference:
http://www.nlm.nih.gov/medlineplus/ency/article/007474.htm.