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.
ECT is used mainly to treat severe depression, but is also indicated for patients with other conditions, including bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, and neuroleptic malignant syndrome.
ECT is among the safest and most effective treatments available for depression. With ECT, electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain.
The Benefits of ECT The greatest benefit of ECT is that it can relieve the symptoms of mental health conditions that were formerly untreatable. It is not a cure, but ECT can help people return to a normal, productive life.
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.
While there are no absolute contraindications to ECT, several relative contraindications exist. These include recent MI or stroke (generally within the last 30 days), increased intracranial pressure, active bleeding (especially from the central nervous system), retinal detachment, and unstable dentition.
Psychosis is perhaps the best-established predictor of ECT response. More than a dozen studies, from the 1950s to the recent Consortium for Research in ECT (CORE) multicenter study, show better response rates for this severe form of depression, in which delusions, paranoia, or both are present.
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.
“The seizure is induced in a very controlled fashion, using a fairly precise delivery of an electric current.” Dr Davey says ECT is seen as a treatment option of last resort, to be used when nothing else has worked, or when there isn't time to find the right medication for a patient, a process that can take months.
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.
Pain relief and anti-nausea medication can help reduce these unwanted effects. Complications of ECT are rare, and unlikely to be life threatening. As with any procedure performed under anesthesia, there is a risk of serious heart problems or other reactions to anesthesia.
These sessions improve depression in 70 to 90 percent of patients, a response rate much higher than that of antidepressant drugs. Although ECT is effective, its benefits are short-lived. For this reason, patients take antidepressant medication after ECT or may continue receiving ECT periodically to prevent relapse.