What Is Electroconvulsive Therapy?
Electroconvulsive therapy (ECT) is a treatment for certain
mental illnesses. During this therapy, electrical currents are sent through the
brain to induce a seizure. The procedure has been shown to help 78
percent of people with clinical depression. It’s most often used to treat people
who don’t respond to medication or talk therapy.
History of ECT
ECT has a checkered past. When ECT was first introduced in
the 1930s, it was known as “electroshock therapy.” In its early use, patients
regularly suffered broken bones and related injuries during therapy. Muscle
relaxants weren’t available to control the violent convulsions caused by ECT.
Because of this, it’s considered one of the most controversial treatments in
In modern ECT, electrical currents are administered more
carefully. Also, the patient is sedated to reduce the risk of injury. Today,
both the American Medical Association and the National Institutes of Mental
Health support the use of ECT.
Why Is ECT Used?
ECT is most often used as a treatment of last resort for the
This mood disorder is characterized by periods of intense
energy and elation (mania) followed by severe depression.
This is a common
mental disorder. People with this disorder experience frequent low moods and a
lack of self-esteem. They may also not enjoy activities they once found
disease typically causes paranoia, hallucinations, and delusions.
Types of ECT
There are two major types of ECT: unilateral and bilateral.
ECT, electrodes are placed on either side of your head. The treatment
affects your entire brain.
ECT, one electrode is placed on the top of your head. The other is
placed on your right temple. This treatment affects only the right side of your
Some hospitals employ
“ultra-brief” pulses during ECT. These last less than half a millisecond,
compared to the standard one-millisecond pulse. The shorter pulses are believed
to help prevent memory loss.
What to Expect
To prepare for ECT, you’ll need to stop eating and drinking
for a specified period of time. You may also need to change certain medications.
Your doctor will let you know how to plan.
On the day of the procedure, your doctor will give you
general anesthesia and muscle relaxants. These medications will help prevent
convulsions. You’ll fall asleep before the procedure and not remember it
Your doctor will place two electrodes on your scalp. A
controlled electrical current will be passed between the electrodes. This
current causes a brain seizure, which is a temporary change in the brain’s
electrical activity. It will last between 30 and 60 seconds.
During the procedure, your heart rhythm and blood pressure
will be monitored. In outpatient procedures, you’ll typically go home the same
Most people receive benefits from ECT in as few as eight to
12 sessions over three to six weeks. Some patients require a once-a-month
How Effective Is ECT?
According to a review by the U.S.
Food and Drug Administration, 78 percent of patients with clinical
depression improved after ECT. In addition, people who are treated with ECT
have a 70
to 90 percent remission rate. This compares to a 20
to 30 percent rate for those taking medications.
The reason ECT is so effective remains unclear. Some
researchers believe it helps to correct an imbalance in the brain’s chemical
messenger system. Another theory is that the seizure somehow resets the brain.
Benefits of ECT vs. Other Therapies
ECT works for many people when drugs or psychotherapy are
ineffective. There are typically fewer side effects than with medications.
ECT works quickly to relieve psychiatric symptoms.
Depression or mania may resolve after only one or two treatments. Many
medications require weeks to take effect. Therefore, ECT can be especially
beneficial for those who are suicidal, psychotic, or catatonic.
However, some people may require maintenance ECT (or
medications) to maintain the benefits of ECT. Your doctor will need to monitor
your progress closely to determine the best follow-up care for you.
ECT may be safely used on both pregnant women and those with
Side Effects of ECT
associated with ECT are uncommon and generally mild. They can include:
- headache or muscle ache in the hours
- confusion shortly after treatment
- nausea, usually shortly after a treatment
- memory loss (short-term or long-term)
- irregular heart rate (rare)
ECT can be fatal,
but deaths are extremely rare. About 1 in 10,000 people die from ECT. This is lower than the U.S. suicide
rate, which is estimated to be 12 in 100,000 people.
If you or a loved
one is dealing with suicidal thoughts, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255 right away.