Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) is a procedure used to treat severe depression. It may be used in people with symptoms such as delusions, hallucinations, or suicidal thoughts or when other treatments such as psychotherapy and antidepressant medicines have not worked. It is also used for other psychiatric and neurological conditions, such as schizophrenia and Parkinson’s disease.
Before ECT, you are given anesthesia to put you in a sleepy state, and you are given medicines to relax your muscles. Then an electrical current is briefly sent to the brain through electrodes placed on the temples or elsewhere on the head, depending on the condition and type of ETC. The electrical stimulation, which lasts up to 8 seconds, produces a short seizure. Because of anesthesia, the seizure activity related to ECT does not cause the body to convulse.
Treatment-Resistant Depression Care
Doctors do not agree on an approach to controlling treatment-resistant depression, also referred to as TRD. Your treatment will depend on your doctor's experience as well as your own needs, concerns, and medical history. But while the details may vary, most doctors follow the same basic pattern. Here is a rough outline of how your doctor might treat your depression. If you have treatment-resistant depression, you have already typically failed two or more treatments, usually one or more antidepressants...
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It is not known exactly how this brain stimulation helps treat depression. ECT probably works by altering brain chemicals (similarly to medicines), including neurotransmitters like serotonin, natural pain relievers called endorphins, and catecholamines such as adrenalin.
ECT treatments are usually done 2 to 3 times a week for 2 to 3 weeks. Maintenance treatments may be done one time each week, tapering down to one time each month. They may continue for several months to a year, to reduce the risk of relapse. ECT is usually given in combination with medicine, psychotherapy, family therapy, and behavioral therapy.
What To Expect After Treatment
Because of the effects of anesthesia, you may not remember the procedure. You may experience some short-term memory loss, confusion, nausea, headache, and jaw pain immediately following ETC. These effects may last several hours. A few people have reported long-term memory loss.1
Why It Is Done
ECT is used for severe depression and other psychiatric or neurological conditions (such as Parkinson’s disease or schizophrenia).
Sometimes ECT is used for older adults who are taking multiple medicines for other illnesses and who are not able to take additional medicines for depression, or for those people who cannot tolerate the side effects of the medicine.
How Well It Works
Studies have shown that ECT is an effective short-term treatment for depression.2
It is important to have follow-up treatment with medicine or maintenance ECT to reduce the risk of relapse.
Risks
In rare cases, ECT may increase blood pressure, cause changes in heart rhythm, or produce seizures that last longer than expected. These physiologic changes typically occur right away after the ECT treatment and can be managed by health professionals doing the procedure, if needed. Often, though, these changes resolve quickly without treatment.
The risks of untreated, severe depression (refractory depression) are often greater than the risks of ETC.
Other side effects of ECT may include headaches, muscle pain, nausea, and short-term and possibly long-term memory problems.
What To Think About
A person having ECT will have a thorough physical exam prior to the treatment.
Complete the special treatment information form (PDF)
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