Schizophrenia and Electroconvulsive Therapy (ECT)

Doctors use electroconvulsive therapy (ECT) to treat severe depression. Sometimes, they also use it to treat other mental illnesses such as schizophrenia.

ECT is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal people or those who have mania or other mental illnesses.

In schizophrenia, ECT is often extremely effective for a syndrome called catatonia, a condition that may coincide with schizophrenia, some forms of depression, and other psychiatric disorders in which a person’s body becomes rigid and cannot be moved.

Doctors may also use ECT to ease other symptoms of schizophrenia, such as delusions, hallucinations, or disorganized thinking.

ECT is traditionally used more often to treat depression or bipolar disorder, however, than schizophrenia. It is thought to be more effective for treating psychosis when mood symptoms are also present. The effectiveness of ECT has therefore not been as extensively studied for treatment of schizophrenia as for mood disorders.

How Is ECT Done?

First, you get general anesthesia and a drug that relaxes your muscles. Then, you get electrodes placed on your scalp. The doctor will send a finely controlled electric current through those electrodes for a very short time. This will cause a brief seizure in your brain.

Because your muscles are relaxed, the seizure may only cause slight movement of your hands and feet. You’ll “wake up” minutes later, and probably won’t remember the treatment. You may be confused for a short time afterward.

Most people get ECT two to three times a week for 2-4 weeks. You’ll probably also get psychotherapy and take medicine under a psychiatrist's care.

Myths About ECT

Many people misunderstand ECT, even though it’s been around since the 1940s. Many of the risks and side effects have been related to anesthesia, doctors using the equipment improperly or doing the ECT in the wrong way, and staff who haven’t had the right training.

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.

Movies and TV shows have shown it incorrectly, adding to the misunderstandings.

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What to Consider

You and your doctor should talk about all your treatment options, in order to find those that are best for you.

If your doctor recommends ECT, you should get a complete medical exam, including your medical history, physical and neurological exams, a heart test called an EKG, and lab tests. Your doctor should closely check what medicines you’ve taken or are taking, too.

Keep in mind that you’ll probably need medicine or other treatment to prevent a relapse. Many doctors suggest follow-up treatment that includes medicine or ECT given less often, called "maintenance ECT."

Side Effects

Short-term memory loss is the major one. This usually goes away within a few weeks after treatment ends.

 

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on March 2, 2018

Sources

SOURCES: 

Rabheru, K. J. ECT. Feb. 9, 2012. 

Petrides, G. Neuropsychobiology, published online, July 29, 2011.

Cleveland Clinic: “Schizophrenia.”

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