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When Is Electroconvulsive Therapy (ECT) Recommended for Depression?

Electroconvulsive therapy (ECT), also known as electroshock therapy, is typically used to treat severe depression. During ECT, a skilled doctor applies a brief electric current through the scalp to the brain while the patient is sedated. This current induces a seizure. ECT is very effective at treating depression.

ECT is generally used when severe depression is unresponsive to other forms of therapy. Or it might be used when patients pose a severe threat to themselves or others and it is dangerous to wait until medications take effect.

For in-depth information, see WebMD's Electroconvulsive Therapy (ECT) for Depression.

What Is the Transcranial Magnetic Stimulation (TMS) Device for Treating Depression?

In 2008, the FDA approved a transcranial magnetic stimulation device for treating major depression in adults for whom one antidepressant has failed to work. It is the least invasive of the brain stimulation techniques used in drug-resistant depression.

While electroconvulsive therapy (ECT or electroshock therapy) uses an electric current to induce seizure, TMS creates a magnetic field to induce a much smaller electric current in a specific part of the brain without causing seizure or loss of consciousness. The TMS device, an electromagnetic coil, is placed against the scalp near the forehead, sending pulses that stimulate nerve cells in the prefrontal cortex region of the brain, which controls mood.

Also unlike ECT, sedation of the patient isn't required. The procedure is done on an outpatient basis four or five times each week for up to six weeks. TMS is considered safe, and studies have shown it can be effective, although it has not been shown to be as effective as ECT.

For in-depth information, see WebMD's video on Brain Stimulation for Depression, and WebMD's High-Tech Treatments for Depression and Therapies for Treatment-Resistant Depression.

What is Vagus Nerve Stimulation (VNS) for Depression?

Vagus nerve stimulation (VNS) is an invasive brain stimulation technique that is also used to treat those with treatment-resistant depression.

The way it works: A pacemaker-like device the size of a pocket watch is implanted in the chest, its wires leading to the left vagus nerve in your neck. The device sends regular electrical impulses to this nerve, which relays information to and from the brain.

For in-depth information, see WebMD's Vagus Nerve Stimulation for Depression.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on May 04, 2013
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