Electroconvulsive therapy (ECT) is typically used to treat severe depression, but it occasionally is used for other mental illnesses such as schizophrenia. During ECT, an electric current is briefly applied through the scalp to the brain to induce a seizure while the patient is asleep under general anesthesia.
You may think holding down a job is too much for someone with schizophrenia. But with treatment, many people can -- and should -- stay in the game.
"People feel better about themselves if they're doing something productive," says Steven Jewell, MD, associate professor of psychiatry at Northeast Ohio Medical University. "It's critical to recovery to move forward with your life, whether it's at school or at work." Jewell advocates a team approach to providing patients the treatment, skills, and support...
ECT is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal patients or patients who suffer from mania or other mental illnesses. ECT is generally used when severe depression is unresponsive to several or more medications or other forms of therapy, or when these patients pose a severe threat to themselves or others and it is dangerous to wait until medications take effect. ECT is also often considered the safest and most effective treatment for mood disorders in women who are pregnant.
In schizophrenia, ECT is often extremely effective for a syndrome called catatonia, an illness in which the patient may not speak, have periods of excitement, or appear motionless and have repetitive, unusual or rigid muscle movements. ECT is also sometimes used for other core symptoms of schizophrenia, such as delusions, hallucinations, or disorganized thinking, but its use is less well-established than for the treatment of mood symptoms.
How Is ECT Performed?
Prior to ECT treatment, a patient is put to sleep using general anesthesia and given a muscle relaxant. Electrodes are placed on the patient's scalp and a finely controlled electric current is momentarily applied, which 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 and awaken minutes later, not remembering the treatment or events surrounding it. The patient is often confused for a short period after treatment. ECT is usually given up to three times a week for two to four weeks.
ECT remains misunderstood by the general public, even though it has been used successfully since the 1940s. Many of the risks and side effects have been related to anesthesia, or the improper use of equipment, incorrect administration, and improperly trained staff.
There is also a misconception that ECT should only be a "last resort" form of treatment, or that it is used as a "quick fix" instead of long-term therapy or hospitalization. Unfavorable portrayals in movies or television shows and misrepresentation in media coverage have added to the controversy surrounding this treatment. In fact, ECT is among the safest and most effective treatments available for depression.