Electroconvulsive therapy (ECT)
About this test
Electroconvulsive therapy (ECT) is a procedure done under general anesthesia. During this procedure, small electric currents pass through the brain, intentionally causing a brief seizure. ECT seems to change brain chemistry, and these changes can quickly improve symptoms of certain mental health conditions.
Why it's done
Electroconvulsive therapy (ECT) can greatly and rapidly improve severe symptoms of several mental health conditions, including: Severe depression, particularly when other symptoms are present, including a break from reality (psychosis), a strong desire to attempt suicide or failure to thrive. Treatment-resistant depression, a severe depression that doesn't get better with medicines 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 impulsive or risky behavior, substance misuse, and psychosis. Catatonia, which features a lack of movement, fast or strange movements, a lack of speech, and other symptoms. It's related to schizophrenia and certain other mental health conditions. In some cases, a medical illness causes catatonia. Agitation and aggression in people with dementia, which can be hard to treat, negatively affect quality of life, and injure and distress others. ECT may be a good treatment when you can't tolerate medicines or you haven't found relief from other forms of therapy. A healthcare professional may recommend ECT: During pregnancy, when medicine might be used less often to reduce the chances of harming the developing fetus. In older adults who can't tolerate drug side effects. In people who prefer ECT treatments over taking medicines. When ECT has worked in the past.
Risks and complications
Although ECT generally is safe, risks and side effects may include: Confusion. You may be confused for a few minutes to several hours after your treatment. You may not know where you are or why you're there. Rarely, confusion may last several days or longer. Confusion generally is more noticeable in older adults. Memory loss. Some people have trouble remembering events that happened right before treatment. Or they may have trouble remembering events in the weeks or months — or, rarely, from previous years — before treatment. This condition is called retrograde amnesia. You also may have trouble recalling events that happened during the weeks of your treatment. For most people, these memory problems usually get better within a couple of months after treatment. Physical side effects. On the days of an ECT treatment, you may have nausea, headaches, jaw pain or muscle aches. A healthcare professional usually can treat these side effects with medicines. Medical complications. As with any medical procedure, especially one that involves medicines that put you to sleep, there are risks of medical complications. During ECT, your heart rate and blood pressure increase for a limited time. If you have serious heart problems, ECT may be riskier.
How to prepare
Before having your first ECT treatment, you'll need a full evaluation that usually includes: A medical history. A physical exam. A mental health assessment. Basic blood tests. An electrocardiogram (ECG) to check your heart health. Discussion of the risks of medicines that make you sleep, called anesthesia. This evaluation helps make sure that ECT is safe for you.
What to expect
The ECT procedure itself takes about 5 to 10 minutes. That does not include the time needed for the healthcare team to prepare and for you to recover. ECT can be done during a hospital stay or as an outpatient procedure.
Understanding your results
Many people begin to notice their symptoms getting better after about six treatments of electroconvulsive therapy. Full improvement may take longer, though ECT may not work for everyone. In comparison, a response to antidepressant medicines can take six weeks. No one knows for certain how ECT helps treat severe depression and other mental illnesses. What is known, though, is that brain chemistry changes during and after seizure activity. These changes may build on one another, somehow reducing symptoms of severe depression or other mental illnesses. That's why ECT works best in people who receive a full course of multiple treatments. Even after your symptoms get better, you'll still need ongoing depression treatment to prevent it from coming back. You may get ECT less often. But treatment often includes antidepressants or other medicines, and talk therapy, also called psychotherapy.
Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.