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Electroconvulsive Therapy (ECT)

ECT is a procedure that passes electric currents through the brain, causing the body to trigger a brief,but intentional seizure. ECT causes changes in the brain’s chemistry that reverse symptoms of mental illnesses. Used as a last resort when other treatments are unsuccessful, especially to end an episode of extreme mania or for someone who is suicidal.

 

Early ECT treatments were given with high doses of electricity without anesthesia. This caused memory loss, fractured bones, and many serious side effects to the patient. However, today ECT is much safer and only given to patients under anesthesia. There are still side effects, but now with electrical currents given in a more controlled setting, there are fewer possible risks and better results. 

     Then              Now

Cases When ECT is Used

(provided by the Mayo Staff Clinic) 

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 that occurs as part of bipolar disorder. Other signs of mania include impaired decision making, impulsive or risky behavior, substance abuse, and psychosis.

 

Catatonia - characterized by lack of movement, fast or strange movements, lack of speech, and other symptoms. It's associated with schizophrenia and some other psychiatric disorders. In some cases, catatonia is caused by a medical illness.

 

Agitation and aggression in people with dementia, which can be difficult to treat and negatively affect quality of life.

 

During pregnancy, when medications can't be taken because they might harm the developing fetus.

 

In older adults who can't tolerate drug side effects.

 

In people who prefer ECT treatments over taking medications.

 

When ECT has been successful in the past.

    Side Effects

 

Confusion – can occur right after treatment and rarely last several days or longer. It’s more common in older adults.

 

Memory Loss – sometimes patients can have retrograde amnesia, which is having trouble remembering events that happened prior to ECT treatment. This includes events that happened weeks, even months leading up to treatment, and in rare cases years. Some people also have trouble remembering events during the week of treatment and after treatment is over. These memory issues usually improve within a couple months.

 

Physical Side Effects - You may experience nausea, vomiting, headache, jaw pain, muscle ache or muscle spasms. These side effects can be treated with medicine.

 

Medical Complications – During ECT, heart rate and blood pressure increase which can lead to serious heart problems. This is common in any procedure involving anesthesia. ECT could put a patient at a higher risk if they have preexisting heart problems. 

Sources

 

"Electroconvulsive therapy (ECT)." <i>Definition</i>. N.p., n.d. Web. 30 July 2014. &lt;http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161&gt;.

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