What is Electroconvulsive Therapy (ECT)?

ECT can be a Good Option When Other Treatments Have Failed

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Electroconvulsive therapy (ECT) is a medical procedure that involves sending an electronic current briefly through a portion of the brain. It is most often used to treat people whose depression is severe or life threatening and/or who cannot take antidepressant medication.

When Electroconvulsive Therapy is Used

Electroconvulsive therapy is generally not used unless other treatment options like antidepressants or psychotherapy have been tried and just aren't relieving symptoms.

If you and your doctor decide that ECT is a good option for you, a complete physical exam should be given before you start treatment since interactions can occur.

ECT is often effective in cases where antidepressant medications do not provide sufficient relief of symptoms, which is generally known as treatment-resistant depression. ECT can also be used for severe mania in people with bipolar disorder; catatonia, which is when the patient is not responding or moving and is usually seen in schizophrenia; and for people who suffer from dementia and are experiencing agitation and aggression.An estimated 100,000 patients receive ECT every year in the United States. 

How ETC Works

In recent years, ECT, which used to be known as electroshock therapy, has been much improved over the horrors we tend to associate with the past when patients were given high amounts of electricity without any anesthesia.

These days, ECT is pretty painless. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses.

The stimulation causes a brief (about 30 seconds) seizure within the brain. It is believed that the seizure influences neurotransmitters in the brain to help them communicate more effectively, which improves your mood.

You do not consciously experience the electrical stimulus since you're under anesthesia and you wake up within five or ten minutes after the treatment. You can even go back to your regular activities within just an hour.

For full therapeutic benefit, at least four to six treatments of ECT are needed for most people, but this depends on how severe your symptoms are, as well as how fast they improve. The initial treatments to get your symptoms under control can be followed by more treatments and/or therapeutic or maintenance treatments that you have less often to help maintain the effects. Your doctor may also recommend that you take an antidepressant too to help with your symptom maintenance.

Risks of Electroconvulsive Therapy

There are some potential side effects from ECT. Physical effects such as headache, upset stomach or muscle pain may occur. Some people experience confusion for a short time after the treatment is complete, but this generally goes away within hours. Short-term and long-term memory loss are also risks.This can be anything from forgetting things that were said right before or after your treatment to not remembering things from weeks or months or possibly, though rarely, even years before your treatment.

Talk to your doctor about whether the benefits of ECT outweigh the risks in your specific situation.

How Effective is ECT?

Encouragingly, the National Institute of Mental Health notes that in one study of patients who underwent ECT, 86-percent of the patients were able to find significant relief from their symptoms of major depression. This study also showed that maintenance treatments are effective in keeping depressive symptoms at bay.

Sources:

"ECT, TMS and Other Brain Stimulation Therapies." National Alliance on Mental Illness (2015).

"Electroconvulsive Therapy (ECT)." Mayo Clinic (2015).

"Brain Stimulation Therapies." National Institute of Mental Health (2015).

"Electroconvulsive Therapy (ECT) ." Mental Health America (2015).

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