Electroconvulsive therapy
Electroconvulsive therapy, formerly known as electroshock therapy, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from mental disorders. The ECT procedure was first conducted in 1938 and rapidly replaced less safe and effective forms of biologi…
What are the benefits of electric shock therapy?
Electric shock treatment 'improves academic performance' Stimulating the brain with tiny electric shocks can boost people’s learning and memory ability, research has found.
What is the Best Shock Treatment?
Shock Treatment
- Lay the Person Down, if Possible. Elevate the person's feet about 12 inches unless head, neck, or back is injured or you suspect broken hip or leg bones.
- Begin CPR, if Necessary. For a child, start CPR for children. ...
- Treat Obvious Injuries
- Keep Person Warm and Comfortable. Loosen restrictive clothing. ...
- Follow Up. ...
What are the side effects of electric shock treatment?
What are the side effects of ECT?
- Memory loss. Many people experience memory loss after having ECT. Some people find this only lasts for a short time and their memories gradually return as they recover from ECT.
- Immediate side effects. You may experience other side effects immediately after treatment. ...
- Longer-term side effects. Was this page useful? ...
Do they still do electric shock therapy?
In fact, ECT is still in use, and why and how it's used may surprise you. Here are some common myths and facts about the procedure. It causes seizures Credit: Getty Images Fact During ECT, a person...
Do they still do electric shock therapy?
But electroconvulsive therapy (ECT) is still being used -- more in Europe than the United States -- and it may be the most effective short-term treatment for some patients with depressive symptoms, a newly published review in the journal The Lancet suggests.
Who needs electric shock therapy?
ECT is a possible treatment for several conditions, including the following: Depression (especially in people who are over the age of 60). Schizophrenia (including other schizophrenia-spectrum conditions and psychotic disorders). Bipolar disorder and other conditions that involve mania.
What is the success rate of ECT therapy?
Typically, ECT (whether inpatient or outpatient) is given two to three times a week for a total of six to twelve sessions. Some patients may need more or fewer treatments. These sessions improve depression in 70 to 90 percent of patients, a response rate much higher than that of antidepressant drugs.
When is ECT recommended?
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 too dangerous to wait until medications take effect.
Can ECT damage your brain?
The review of literature and present evidence suggests that ECT has a demonstrable impact on the structure and function of the brain. However, there is a lack of evidence at present to suggest that ECT causes brain damage.
Why do patients get electric shocks?
ECT is used to treat: Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. Treatment-resistant depression, a severe depression that doesn't improve with medications or other treatments.
Who is a candidate for ECT therapy?
People who have had ECT before and responded well are good candidates for ECT. Other first-line indications for the procedure include people who are catatonic or suffering from a form of depression known as psychotic depression (depression associated with delusions and hallucinations).
Can ECT change your personality?
ECT does not change a person's personality, nor is it designed to treat those with just primary “personality disorders.” ECT can cause transient short-term memory — or new learning — impairment during a course of ECT, which fully reverses usually within one to four weeks after an acute course is stopped.
What are the side effects of ECT?
The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours. These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders.
Is ECT worth the risk?
Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions. Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression.
Why is ECT a last resort?
ECT is too often considered as a last resort, rather than as a first-line treatment, a status that some states have even written into law. ECT's controversial history and the consequent reluctance of patients to accept it without trying other alternatives may also be a barrier to its increased use.
Is ECT used for anxiety?
ECT is not used to treat anxiety and therefore does not have a role in people who have solely an anxiety disorder. ECT may have a role in people who have comorbid depression and anxiety.
Why is electroconvulsive therapy used?
Why it's done. Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat: Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. Treatment-resistant depression, ...
What is ECT used for?
ECT is used to treat: Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. Treatment-resistant depression, a severe depression that doesn't improve with medications or other treatments. Severe mania, a state of intense euphoria, agitation or hyperactivity ...
What is ECT in medical terms?
Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.
How often do you get ECT?
In the United States, ECT treatments are generally given two to three times weekly for three to four weeks — for a total of six to 12 treatments. Some doctors use a newer technique called right unilateral ultrabrief pulse electroconvulsive therapy that's done daily on weekdays.
What is the test called when you have a seizure?
Internally, activity in your brain increases dramatically. A test called an electroencephalogram (EEG) records the electrical activity in your brain. Sudden, increased activity on the EEG signals the beginning of a seizure, followed by a leveling off that shows the seizure is over.
Is it safe to take ECT?
Risks. Although ECT is generally safe, risks and side effects may include: Confusion. Immediately after treatment, you may experience confusion, which can last from a few minutes to several hours. You may not know where you are or why you're there. Rarely, confusion may last several days or longer.
When is ECT administered?
Promotional materials are careful in describing the procedure and present a picture that’s quite benign: “ECT treatment is generally administered in the morning, before breakfast,” reads one brochure. “Prior to the actual treatment, the patient is given general anesthesia and a muscle relaxant.
Why did terror stalk the halls of euthanasia hospitals?
According to history professor Henry Friedlander, “Terror stalked the halls of the euthanasia hospitals not only because patients feared being selected for killing at any time or because some of the staff beat and maltreated them, but also because some medical procedures imposed unusual pain.”.
What machines were used in the Moroccan prison system?
The center also had several Page-Russell electroshock machines, which were routinely used on prisoners. During the post-shock periods, Moroccan physicians questioned the detainees, seeking information about opponents to the king.”.
Does electric current cause seizures?
While the modern procedure is generally carried out without busted teeth and the more grisly features of its early practice, the principle is still the same: Electric current blazes through the brain to provoke a seizure—the logic being that seizures occurring in the brain have some therapeutic benefit, somehow.
Does electricity shock the brain?
And Baughman says using electricity to shock the brain into a seizure—no matter how you do it—results in real and lasting harm. “You are creating a seizure which is prima facie evidence of brain damage,” he observes.
What is electric shock therapy?
Electric shock therapy, better known as electroconvulsive therapy, is used to treat myriad mental illnesses, including severe depression, mania, and schizophrenia . It is not an appropriate choice for individuals living with mental illnesses treated effectively with talk therapy or medication.
How long does electric shock therapy take?
Electric shock therapy is completed over several sessions. These sessions are often administered over two to four weeks, at a rate of up to three sessions per week. Most sessions take between five and ten minutes, but preparation and recovery time can extend treatment time. Electric Shock Therapy Of The Past.
What is the name of the movie that depicts electric shock therapy?
Infamously depicted in the 1975 film One Flew Over the Cuckoo's Nest , electric shock therapy has gained a reputation as a brutal and inhumane punishment for those struggling with their mental health. This film does indeed portray the reality of a small portion of patients from the early days of electric shock therapy treatment.
What are the side effects of electric shock?
Physical Issues:Directly after electric shock therapy, some patients may experience physical side effects, such as nausea, headaches, jaw tension, or muscle pains. These side effects are typically short-lived and can be treated with over-the-counter medications.
Can shock therapy help with depression?
Shock Therapy For Depression: Individuals with severe forms of depression may find relief in electric shock therapy. Depression may be accompanied by psychosisor intense suicidal ideation. Depression that is resistant to medications and other treatment also makes an ideal candidate for shock therapy.
Is electric shock therapy considered anesthesia?
Patients also reported long-term and debilitating confusion. Electric shock therapy was often administered without anesthesia or muscle relaxants, so patients were conscious throughout the procedure. Little action was taken to mitigate these and other negative side effects of the treatment.
Is electric shock therapy a medical treatment?
Electric Shock Therapy Of The Past. Electric shock therapy has changed and developed over its life as a medical treatment. For instance, shock therapy for depression has its origins in the eighteenth-century, when the London Medical Journalcited intentional seizure induction as a treatment for various psychiatric disorders.
What is shock therapy?
"Shock therapy" was so-called, as an electric shock is used to induce a controlled seizure intended as a treatment , primarily for mood disorders, although other conditions may be treated as well. Shock therapy is now known as electroconvulsive therapy or ECT.
Where is shock therapy performed?
Shock therapy is performed in a hospital, sometimes in an area specifically set aside for this treatment. An intravenous (IV) is inserted to provide anesthetic medication. Vital signs are taken initially and continuously throughout the shock therapy treatment.
How does shock therapy feel?
How Shock Therapy Feels. When you awake from the anesthesia, you may be confused and tired. You will likely experience short-term memory loss around the time of the procedure. With multiple treatments, this may increase. Adverse cognitive effects tend to be the most concerning factors around ECT and tend to affect the frequency and duration ...
What is the name of the drug that is used to treat seizures?
A paralyzing agent called succinylcholine is then administered to prevent the seizure from spreading to your body. The electrodes are then applied to your head with conducting jelly and a brief shock (less than 2 seconds) is administered.
How to know if you are recovering from shock?
Your vital signs will be monitored closely after the shock treatment to ensure proper recovery. You may feel head, muscle or back pain. Such discomfort tends to be relieved by mild medications. If any post-treatment effect is concerning you, you should talk to the treating physician immediately.
Is electroconvulsive therapy effective?
Electroconvulsive therapy has also shown effectiveness in treating other disorders such as neuroleptic malignant syndrome (a rare, severe, adverse reaction to antipsychotic medication). Shock treatment for depression and other disorders is indicated when the patient needs rapid improvement because the patient is:
Does mania respond to shock?
Mania also often responds well to shock treatment. The picture is not as bright for schizophrenia, which is more difficult to treat and is characterized by frequent relapses. A small number of patients are placed on maintenance shock therapy.
What is ECT therapy?
Therefore, ECT therapy is most commonly used in severe major depression or bipolar disorder that have failed to respond to traditional methods of cognitive-behavioral therapy, medication, or talk therapy. The most common side effects of electroconvulsive therapy (ECT) are:
Where do you put electrode pads for ECT?
Then, they place electrode pads at specific places on your head. For example, if you have bilateral ECT, the leads will be on both sides of your head. For unilateral ECT, they'll only be on one side of your head.
Why do doctors use ECT?
Doctors these days are much more hesitant to use ECT than passed, if for no other reason than because people are typically opposed. In addition, ECT is required by law to be used only by your consent or under the most severe conditions, such as: 1 To save your life 2 If urgently needed to prevent a rapid worsening of your condition
What is the result of ECT?
The result is that they respond more positively to cues in their environment. The amygdala, the structure in the brain involved with experiencing emotions, also changes structurally following ECT. These changes are currently being studied to understand better why ECT helps certain people and not others.
What do doctors do before giving you ECT?
Before making the final decision to give you ECT, your doctor will take your medical history, give you a physical exam, do a psychiatric assessment, take basic blood tests, and do an ECG to check your heart.
Is shock therapy safe?
Risks And Side Effects Of Shock Therapy. Modern ECT is a very safe procedure, but there are a few risks and side effects. Because this is a medical procedure that uses general anesthesia, you may suffer medical complications. In addition, the treatment always causes increases in heart rate and blood pressure.
Can you get shock treatment with ECT?
If your doctor has suggested ECT as a possible treatment for you or a loved one, you need to make sure you understand what your specific treatment will be done and what results you can achieve from it. However, you may be worried that you'll be given shock treatment against your will if you seek treatment for psychiatric problems. That's why it's important to find out all you can as soon as possible.
What is the treatment for ECT?
This typically means psychotherapy and/or medication or, in some circumstances, ongoing ECT treatments.
What is ECT therapy?
What is Electroconvulsive therapy (ECT)? Electroconvulsive therapy (ECT) is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has not responded to other treatments. ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia.
What are the side effects of ECT?
The most common side effects of ECT on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours.
Is ECT effective for mental health?
ECT’s effectiveness in treating severe mental illnesses is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health, and similar organizations in Canada, Great Britain and many other countries. Although ECT can be very effective for many individuals with serious mental illness, ...
Is ECT good for depression?
Extensive research has found ECT to be highly effective for the relief of major depression. Clinical evidence indicates that for individuals with uncomplicated, but severe major depression, ECT will produce substantial improvement in approximately 80 percent of patients. It is also used for other severe mental illnesses, ...
What is ECT therapy?
What is electroconvulsive therapy (ECT)? Electroconvulsive therapy, or ECT for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain (also known as a seizure).
Why is ECT used?
The National Institute for Health and Care Excellence (NICE) recommends that ECT is only used to achieve quick, short-term improvements if you have: severe or life-threatening depression and your life is at risk so you need urgent treatment.
What are the benefits of ECT?
The National Institute for Health and Care Excellence (NICE) recommends that ECT is only used to achieve quick, short-term improvements if you have: 1 severe or life-threatening depression and your life is at risk so you need urgent treatment 2 moderate to severe depression and other treatments such as medication and talking therapies haven't helped you 3 catatonia (staying frozen in one position, or making very repetitive or restless movements) 4 a severe or long-lasting episode of mania.
Is repeated ECT good for schizophrenia?
a severe or long-lasting episode of mania. Repeated ECT is only recommended if you have previously responded well to it, or if all other options have been considered. ECT is not recommended for ongoing management of schizophrenia, or as a routine treatment for mild to moderate depression.
How does a cardioversion machine work?
You will receive medicine through a vein in your arm to make you fall asleep. Using the cardioversion machine, a programmed high-energy shock is sent to your heart. This should convert your heart back to a normal rhythm.
Is electrical cardioversion better than chemical cardioversion?
Electrical cardioversion works better and is used more often than chemical cardioversion. Your healthcare provider may not want you to have cardioversion if you have minor symptoms. It also may not be recommended if you are elderly, if you have had AFib a long time, or if you have other major medical problems.
Is electrical cardioversion good for AFIB?
Other treatments might be better for you, like heart rate control with medicines. Electrical cardioversion is also useful for treating other abnormal heart rhythms, like atrial flutter, which is similar to AFib.
Overview
Why It's Done
- Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat: 1. Severe depression,particularly when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat. 2. Treatment-resistant depression,a severe depression that ...
Risks
- Although ECT is generally safe, risks and side effects may include: 1. Confusion.Immediately after treatment, you may experience confusion, which can last from a few minutes to several hours. You may not know where you are or why you're there. Rarely, confusion may last several days or longer. Confusion is generally more noticeable in older adults. 2. Memory loss.Some people hav…
How You Prepare
- Before having your first ECT treatment, you'll need a full evaluation, which usually includes: 1. Medical history 2. Complete physical exam 3. Psychiatric assessment 4. Basic blood tests 5. Electrocardiogram (ECG) to check your heart health 6. Discussion of the risks of anesthesia These exams help make sure that ECT is safe for you.
What You Can Expect
- The ECT procedure takes about five to 10 minutes, with added time for preparation and recovery. ECT can be done while you're hospitalized or as an outpatient procedure.
Results
- Many people begin to notice an improvement in their symptoms after about six treatments with electroconvulsive therapy. Full improvement may take longer, though ECT may not work for everyone. Response to antidepressant medications, in comparison, can take several weeks or more. No one knows for certain how ECT helps treat severe depression and other mental illness…
Terminology
Mechanism
- The brain is still not well understood, nor is the reason for the treatment effects ECT (shock) therapy has on some individuals. It is known that ECT affects hormones, neuropeptides, neurotrophic factors, and neurotransmitters in the brain. All of this may come together to explain how ECT works in treatment.
Preparation
- A full physical is generally needed before shock therapy. Because general anesthesia will be administered, one should not eat or drink 8-12 hours before the shock treatment. This helps to prevent any vomiting during the procedure. Other exams like an electrocardiogram (ECG) may also be given before ECT to ensure the procedure is safe and appropriate.
Treatment
- Shock therapy is performed in a hospital, sometimes in an area specifically set aside for this treatment. An intravenous (IV) is inserted to provide anesthetic medication. Vital signs are taken initially and continuously throughout the shock therapy treatment. An anesthesiologist administers anesthesia and after you are asleep, places a tube in your throat to help you breathe…
Results
- When you awake from the anesthesia, you may be confused and tired. You will likely experience short-term memory loss around the time of the procedure. With multiple treatments, this may increase. Adverse cognitive effects tend to be the most concerning factors around ECT and tend to affect the frequency and duration of treatments and whether ECT is offered at all. Your vital si…
Uses
- It is most common to see shock therapy used in severe cases of depression. Shock therapy is also performed to improve the condition of the following disorders:1
Risks
- The complications associated with ECT / shock therapy are often related to electrode placement with bilateral placement (an electrode by each temple) typically showing greater unwanted cognitive effects than unilateral placement (one electrode at the temple and the other on the forehead). Risks of shock therapy include slow heart beat (bradycardia) and rapid heartbeat (tac…
Prognosis
- Shock treatment for depression often produces a dramatic improvement in symptoms, especially in elderly individuals, sometimes during the first week of treatment. While it is estimated many of these patients will experience a future return of depression symptoms, the prognosis for each episode of depression is good. Mania also often responds well to shock treatment. The picture i…