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Electroconvulsive therapy

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a medical treatment for severe depression with suicidal ideas or attempts, catatonia and severe/acute cases of mania & schizophrenia. It is also given to patients who do not show any response to medication, have not tolerated the medication and have marked symptoms of agitation or stupor.

ECT is not a surgical procedure. The procedure involves a small electrical current being carefully passed through the brain under anesthesia. It is a safe, painless and very effective therapy in treating psychiatric disorders.

Why ECT is used?

ECT can improve depression in nearly 70% of patients, and has been proven to help with other conditions such as mania and schizophrenia. The effect is rapid and can be a life-saving treatment for people who are at risk of suicide/homicide, or who are not eating or drinking because of their mental illness. It’s safe and there are few side effects.

ECT is given in a hospital. It can be done in inpatient (staying overnight) or an outpatient (coming into hospital for the day) basis.

What is done during ECT?

Family members are psycho educated about the use of ECT and its quick benefits. Once relatives are satisfied and willing to carry out the therapy then the procedure is started. After anesthesia and muscle relaxation psychiatrist places two electrodes on your head and deliver a short electrical pulse. The treatment takes about 20 to 30 seconds. Patient is unaware during the treatment. Electric stimulation is given for 1 second. Patient is then moved to the recovery ward to wake up from the anaesthetic. The whole procedure takes around 10–20 minutes. If ECT is given on outpatient basis at the hospital patient will be able to go home the same day.

On average around 8–12 sessions of ECT are given in a treatment course, with a few days between sessions. More sessions may be needed depending on the condition and response.

Who can give ECT?

Only approved psychiatrists with training should give ECT.

How does ECT work?

The small electrical current stimulation increases the level of electrical activity in the brain. Current scientific evidence suggests that ECT may rebalance the neuro-chemicals in brain that that are altered in mental illnesses.

 

Safety

ECT is a very safe treatment.  The risks are similar to any minor medical procedure given under general anaesthetic.

Does ECT cure depression?

Around 60–70% of people who have ECT for depression say their symptoms clear completely. Up to 80% say they get some benefit.

What are the side effects of ECT?

Loss of short-term memory

A small number of people who have ECT can’t remember what happened on the morning of treatment or the day before, or have patchy memories of the time.  Some have trouble remembering or concentrating for the day after the treatment. However, depression alone can cause the same symptoms. These kinds of memory problems will go away after few days of course of ECT .

Short term side effects include headache, confusion and mild cognitive slowing.              

Muscle soreness, nausea, vomiting and occasionally back pain.

Myths and fears about ECT

Will I get brain damage? - No. Scientific studies have shown that ECT does not damage the brain.

Does ECT hurt? - ECT does not hurt. Patient is under anesthesia during the procedure. One may have a headache, body aches or nausea from the anaesthetic agent after waking up.

Getting ECTs is scarry - Some people are worried about ECT because of the way it has been shown in films. In the past ECT was given without anaesthetic.

Modern ECT is safe, painless and effective, and is administered by highly trained specialists.

Can someone be given ECT if they don’t want it?

Before any ECT treatment is given, psychiatrist must make it sure that the consent is taken from patient or relative for having ECT and patient and family members have full right to refuse ECTs.