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Who should use electroconvulsive therapy?

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.

When should you consider ECT?

It should be considered in cases of treatment-resistant depression, schizophrenia, and mania. It should also be considered as a first-line treatment in certain urgently ill patients who require rapid response due to the severity of their medical or psychiatric illness.

What patients benefit from ECT?

ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients. It's also very effective for patients who suffer from mania or a number of other mental illnesses.

Who should not use ECT?

Do not use electroconvulsive therapy (ECT) routinely for people with moderate depression but consider it if their depression has not responded to multiple drug treatments and psychological treatment.

What are the pros and cons of electroconvulsive therapy?

The Pros & Cons Of ECT First and foremost, the treatment requires sedation, making recovery complex and much longer. Second, ECT has a higher chance to cause serious side effects for some individuals, including memory loss, which can deter potential patients. Pros of ECT: Safer today than previous ECT treatments.

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.

Is ECT used for schizophrenia?

Electroconvulsive therapy (ECT) was initially used for the treatment of schizophrenia, but over the years with the advent of antipsychotics, its use in schizophrenia has been limited. Treatment guidelines vary in their recommendations for the use of ECT in schizophrenia.

Does ECT help social 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 ECT used for depression?

With ECT, an electrical stimulation is delivered to the brain and causes a seizure. For reasons that doctors don't completely understand, this seizure helps relieve the symptoms of depression. ECT does not cause any structural damage to the brain.

Why is ECT controversial?

Reasons for Controversy Three reasons are given for the aversion: 1) ECT is considered old-fashioned and politically incorrect; 2) it is forced on the patient; and 3) the memory disturbances are so severe and persistent that no rational human being would undergo this procedure, no matter how well-intended.

Does ECT work for everyone?

ECT does not work for everyone. It will not cure your underlying illness. Many patients need continuing treatment after doing ECT. This could include maintenance ECT treatments, talk therapy, medicine, or a combination of the three.

Why is ECT a last resort?

“ECT is often considered a last resort by patients and providers,” says senior author Daniel Maixner, M.D. “Unfortunately, research shows that with multiple medication failures and long duration of illness -- sometimes many years -- the chance that patients can achieve remission drops quickly to very low numbers.

How many people are treated with ECT?

Today, ECT is administered to an estimated 100,000 people a year, primarily in general hospital psychiatric units and in psychiatric hospitals. It is generally used in treating patients with severe depression, acute mania, and certain schizophrenic syndromes.

When is ECT administered?

ECT treatment is generally administered in the morning, before breakfast. Prior to the actual treatment, the patient is given general anesthesia and a muscle relaxant. Electrodes are then attached to the patients scalp and an electric current is applied which causes a brief convulsion. Minutes later, the patient awakens confused ...

What is ECT in medical terms?

What is ECT? Electroconvulsive therapy (ECT) is a procedure in which a brief application of electric stimulus is used to produce a generalized seizure. It is not known how or why ECT works or what the electrically stimulated seizure does to the brain.

Is ECT a long term treatment?

After 60 years of use, ECT is still the most controversial psychiatr ic treatment. Much of the controversy surrounding ECT revolves around its effectiveness vs. the side effects, the objectivity of ECT experts, and the recent increase in ECT as a quick and easy solution, instead of long-term psychotherapy or hospitalization.

Is ECT a history of abuse?

The nature of ECT, its history of abuse, unfavorable medical and media reports, and testimony from former patients all contribute to the debate surrounding its use. Research should continue, and techniques should be refined to maximize the efficacy and minimize the risks and side effects resulting from ECT.

Is ECT effective after a relapse?

It is also unclear whether or not ECT is effective. In some cases, the numbers are extremely favorable, citing 80 percent improvement in severely depressed patients, after ECT. However, other studies indicate that the relapse is high, even for patients who take medication after ECT.

What do you need to know before ECT treatment?

Before a course of ECT treatments, you will need a full medical examination to make sure the treatment is safe for you. You will be asked about: your medical history – in case you have other health problems that should be treated first, or which mean you shouldn’t have the treatment.

Can ECT prevent depression?

ECT can’t prevent future depression, or fix any ongoing stresses or problems that are contributing to how you’re feeling. Some people have very bad experiences of ECT, for example because they feel worse after treatment or are given it without consent. You might not want to risk the possibility of getting side effects.

Can you have ECT for depression before?

have already been helped by the treatment so you don't need any more. show signs of serious adverse effects, such as memory loss. If you have had ECT for depression before and it didn't help, you should only be given it again if: you and your doctors are sure that all other possible treatments have been tried.

Can you take ECT while pregnant?

whether you are pregnant – ECT can be used in pregnancy, but there may be concerns about giving you anaesthetic while pregnant. any medicine you are taking – some prescribed drugs can affect your response to ECT, meaning the treatment needs to be adjusted. any allergies you have.

Can you have ECT if you are unwell?

Deciding whether or not to have ECT can be difficult. Usually you will only be offered it if you are very unwell, so you might find it harder to take in information and make decisions. You should be given full information about the treatment so you can make an informed decision. Unless you are unable to make the decision for yourself, ...

Does ECT help with depression?

ECT could be helpful if you have stopped eating and drinking or looking after yourself due to severe depression. If you have depression after having a baby (also known as postnatal depression ), ECT might make it easier to care for and bond with your baby.

What Is ECT?

Patients are generally given a muscle relaxant before being placed under anesthesia.

Why You Might Need ECT

According to the Mayo Clinic, there are several reasons you might need ECT.

The Side Effects & Risks of ECT

As with any medical procedure, there are risks to ECT. It has been associated with difficulty learning as well as short-term memory issues. Some patients have reported difficulty remembering recent events that occurred in the week (s) before treatment. In the majority of cases, these memory issues resolve within a month or two of treatment.

How can families help with ECT?

Families can help by providing a gentle reminder of the day and date and that feeling confused is to be expected. Family members should inform the nurse of any concern they have about their loved one. View a Powerpoint Presentation for Families about ECT.

How does ECT work?

Why does ECT work? No one is sure how ECT helps certain psychiatric disorders. It may promote changes in how brain cells communicate with each other at synapses and it may stimulate the development of new brain cells. ECT may flood the brain with neurotransmitters such as serotonin and dopamine, which are known to be involved in conditions like ...

How long does an ECT procedure last?

How long is an ECT procedure? A single ECT session usually lasts one hour. This includes the time the patient will be in the treatment room (approximately 15-20 minutes) and the time spent in the recovery room (approximately 20-30 minutes). Typically, ECT (whether inpatient or outpatient) is given two to three times a week for a total ...

How long does it take to drive after ECT?

Usually this takes about 20 to 25 minutes. Patients who are given ECT on an outpatient basis must have someone drive them home after the procedure and stay with them until they go to sleep at night. People should not drive in the 24 hours following ECT.

What are the two electrodes used for?

Two of these electrodes are for monitoring the brain waves. The other two are for delivering a short, controlled set of electrical pulses for a few seconds. The electrical pulses must produce a generalized seizure to be effective.

How long does it take to sleep before ECT?

During the procedure, the patient receives a short acting anesthetic agent which puts the patient to sleep for approximately 5-10 minutes.

Can memories be lost after ECT?

Memories formed closer to the time of ECT are at greater risk of being lost while those formed long before ECT are at less risk of being lost. The ability to form new memories is also impaired after a course of ECT treatments but this ability usually makes a full recovery in the weeks and months following the last treatment.

How often do you have to do ECT?

ECT requires a series of treatments, often initiated two to three times a week for a few weeks and then the frequency is tapered down. As the treatment course progresses, short-term memory loss for things recently learned is not uncommon.

How long does it take to get an ECT?

The ECT procedure takes around five to 10 minutes to perform, not including preparation and recovery time. The day before the procedure, you would be placed on dietary restrictions, typically with no food or drink allowed after midnight and only a sip of water permitted in the morning to take medication.

What doctor would you meet with to see if you have had anesthesia?

You may also meet with the anesthesiologist who will inquire whether you have had anesthesia in the past and if there were any adverse reactions.

Is electroconvulsive therapy safe?

Electroconvulsive therapy (ECT) is a safe and effective treatment for certain psychiatric disorders such as major depression, catatonia, certain types of psychosis, and sometime for bipolar mania .

Is ECT scary?

While ECT is a scary concept to most people, by understanding the procedure and what to expect, you can make a more informed choice if the treatment is recommended for you. Overview of Electroconvulsive Therapy.

Why is ECT used?

Understandably, people benefiting from ECT want normalcy without the label of mental illness. ECT is often used in critical situations in an effort to avoid suicide. I know from personal experience. After three suicide attempts, ECT provided a quick and clear path out of my depression.

Does ECT have a lifetime guarantee?

Health does not come with a lifetime guarantee. As with any major medical procedure, patients must compare risks to benefits, then decide if the upside outweighs the risks. ConnECT group films a piece about their experience with ECT. Some who consider ECT worry about memory loss.

Is ECT good for depression?

For those who are profoundly depressed, the medical community often cites ECT as the gold standard, with a high remission of symptoms, far better than antidepressants alone.

Does ECT cause brain damage?

When ECT is properly administered, brain damage does not occur. In fact, research has shown that ECT increases brain-derived neurotrophic factor, which stimulates brain cell growth.

Does ECT work temporarily?

Some argue that ECT only works temporarily, the high relapse rate invalidating the procedure. Sackeim et. al. reported in the Journal of American Medical Association in 2001 that 61% of the patients treated with a combination of medication and ECT were in remission at 6 months.

Why should patients with a history of heart problems not undergo ECT treatment?

Patients with a history of heart problems generally should not undergo ECT treatment, because the risk associated with receiving the electrical stimulation is greater. Last medically reviewed on May 17, 2016.

What is the side effect of ECT?

Memory Loss. Memory loss is the primary side effect associated with ECT treatment. Most people experience what’s called retrograde amnesia, which is a loss of memory of events leading up to and including the treatment itself. Some people’s memory loss is longer and greater with ECT. Some have trouble recalling events that occurred during ...

What happens if your doctor fails to do so?

If your doctor fails to do so, that may be a sign they minimize the risks associated with ECT . 1.

How long does confusion last after electroconvulsive therapy?

Many people who undergo the electroconvulsive therapy find that they experience a period of confusion after the procedure has been completed. You may forget why you’re in the hospital, or even what hospital you’re in. For most people, this confusion fades after a few hours, but can last as long as a few days after ...

How long does it take for memory to improve after ECT?

Memory loss generally improves within a few weeks after ECT treatment. As with psychiatric medications, no professional or doctor can tell you for certain what kind of memory loss you will experience, but virtually all patients experience some memory loss. Sometimes the memory loss in some patients is permanent. 2.

Who performs electroconvulsive therapy?

ECT is a medical procedure that can only be performed by a qualified physician or psychiatrist. Because general anesthesia is administered, electroconvulsive therapy carries with it similar risks that any medical procedure using anesthesia does.

Can ECT cause headaches?

4. Other Side Effects. Similar to some psychiatric medications, some people undergoing ECT may experience physical side effects such as nausea, headaches, muscle aches or spasms, and vomiting.

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 e…

See more on mayoclinic.org

Risks

How You Prepare

What You Can Expect

Results