Bipolar Disorder: Electroconvulsive Therapy (ECT) for Bipolar Disorder

Electroconvulsive therapy (ECT), also known as electroshock therapy, is used as an acute treatment for hospitalized patients who are suicidal, psychotic, or dangerous to others. It is effective in nearly 75% of patients who have the procedure.

In electroconvulsive therapy, an electric current is sent through the scalp to the brain. It is used to treat people who are suffering from severe depression or other mental illness. ECT is one of the fastest ways to relieve symptoms in people who suffer from mania or severe depression. ECT is generally used as a last resort when the illness does not respond to medication or psychotherapy. It is also used when patients pose a severe threat to themselves or others and it is dangerous to wait until drugs take effect.

Prior to ECT treatment, a person is given a muscle relaxant and put under general anesthesia. ECT, when done correctly, will cause the patient to have a seizure, and the muscle relaxant is given to limit muscle response during  the episode.

Electrodes are placed on the patients scalp and a finely controlled electric current is applied that causes a brief seizure in the brain. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet. Patients are carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and is often confused.

This confusion typically lasts for only a short period of time. ECT is given up to three times a week for two to four weeks.

In extremely rare cases, ECT can cause heart attack, stroke, or death. People with certain heart problems usually are not good candidates for ECT. Short-term memory loss is the major side effect, although this usually goes away one to two weeks after treatment.

Other possible side effects include:

• Confusion
• Nausea
• Headache
• Jaw pain

These effects may last from several hours to several days.

A third of people who have ECT report some residual memory loss, but this is usually limited to the time surrounding the giving of the ECT treatment.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.