Electroconvulsive therapy (ECT) is a procedure where electric currents are directed to the brain. ECT treatments can provide a fast and considerable reduction of symptoms for people with severe depression as well as other mental health conditions, which can include:

  • bipolar disorder
  • schizophrenia
  • catatonia
  • dementia

The US Surgeon General, the National Institute of Mental Health, and the American Psychiatric Association have all endorsed ECT as a tool for treating major depression and some psychiatric disorders.

ECT is not typically recommended as the first option of treatment. It is prescribed when medications do not work, or when an individual cannot take medications due to the severity of side effects or another medical condition. It can be recommended when a person requires rapid treatment because they are at risk of suicide. Older adults and pregnant women may be good candidates for ECT as well.

How Does ECT Work?

Before the electric current is administered, a patient is put under general anesthesia and given a muscle relaxant. Electrode pads are placed on one or both sides of the patient’s head. A machine administers a small electric current to the electrodes, which produce a small seizure in the brain that lasts roughly one minute. This causes brain activity to increase. Including prep and recovery time, the entire session lasts around one hour.

Researchers do not understand exactly why ECT helps minimize the symptoms of depression and other mental illnesses. They speculate that it may trigger the development of brain cells, or allow brain cells to communicate better. The procedure also may promote the release of neurotransmitters like serotonin and dopamine, which can alleviate the symptoms of depression or schizophrenia.

ECT can be done while a patient is hospitalized or as an outpatient procedure. A patient typically receives 6 to 12 treatments over the course of a few weeks, depending on the severity of symptoms.

Side Effects 

After an ECT procedure, a patient may experience a period of confusion and not know where they are. Disorientation can last for several hours. A patient may also experience side effects which include:

  • Headaches
  • Nausea
  • Muscle pain
  • Loss of memory

People experiencing memory loss may not remember events occurring in the days, weeks, or months prior to treatment. They can also forget events that happen after the treatment. Typically, memory loss will improve in the days and weeks after treatment. Memory loss is more commonly associated with a type of ECT known as bilateral ECT..1  

There are risks associated with any medical procedure in which anesthesia is required. ECT also can be risker for individuals with heart conditions.

Is ECT Dangerous or Painful?

Researchers and medical professionals assert that ECT is safe and effective. The patient is unaware during the procedure, and the muscle relaxant administered helps prevent convulsions from the seizure. A patient may experience some mild achiness or soreness after the procedure.

There is some stigma surrounding ECT because it has been portrayed negatively in movies and other media. The procedure has been around since the 1930s, and many years ago there was a risk of injury because of the seizure convulsions produced by ECT. But improvements in the procedure over the years have eliminated these risks.

Can ECT Cause Brain Damage ECT?

Many studies have demonstrated that ECT causes no structural brain damage and may even promote positive nerve growth in the brain. Some researchers debate whether ECT can cause long-term memory loss. This can be difficult to determine because severe depression can also interfere with memory.

How Long Does Recovery Take?  

Patients often feel drowsy or disoriented after an ECT treatment. Recovery also can depend on whether a person experiences confusion or memory loss after ECT. Most people can resume daily activities a few hours after receiving ECT. However, most doctors recommend that you wait at least 24 hours or longer before you drive or engage in other potentially hazardous activities.

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Can ECT Treat the Symptoms of Schizophrenia?  

Though ECT is primarily used to treat the symptoms of severe depression, it is sometimes used to treat other mental health conditions, like schizophrenia. Typically, people with schizophrenia who receive ECT experience some mood-related symptoms.

Antipsychotic medications are the first course of treatment for people with schizophrenia. But a significant percentage of patients are nonresponsive to these medications. Patients have been shown to respond well to ECT when they are resistant to particular antipsychotic medications, in particular, the drug clozapine.2

Most studies reporting the effectiveness of ECT in schizophrenia report significant improvement of symptoms, and none report a worsening of symptoms. The response rate also tends to be higher when patients are receiving both medication and ECT. In particular, symptoms of schizophrenia such as delusions, hallucinations, and disorganized speech tend to improve.

What Is The Success Rate of ECT?

Electroconvulsive therapy has proven to be incredibly effective in treating major depressive disorder. 70 to 90% of patients with severe depression will experience substantial improvement of symptoms.3

One study of patients with schizophrenia receiving ECT found that 70% of patients experienced at least a 20% reduction in symptoms, and half experienced at least a 40% reduction. These patients were also taking the antipsychotic clozapine.4 Another study reported a response rate of 77% from patients receiving ECT, and 9% of the participants reported temporary cognitive impairment.5

ECT does not cure depression, schizophrenia, or other mental health conditions. Though it can alleviate symptoms, patients will require continued treatment including psychotherapy and medication to manage their mental health.

Is ECT Right For Me?

If you think that ECT might alleviate the symptoms of your mental health condition, talk to your doctor or psychiatrist. Though ECT can be very effective, so can medication, therapy, and many other interventions. The treatment is recommended for people who are not responsive to medication or who have medical conditions which make taking medication much riskier. Regardless, talking to your doctor or psychiatrist can help you make the most informed decision about your mental health.

 

 

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Last Updated: Jul 17, 2019