Electroconvulsive therapy





What is Electroconvulsive therapy (ECT)?

How is ECT performed?

When do we use ECT?

What diseases and disorders can be treated with ECT?

Is ECT a definitive treatment?

Benefits and risks of ECT

What are the complications of ECT?

Steps to perform ECT

How many sessions of ECT are needed?

ECT emergencies


What is ECT?

ECT or electroconvulsive therapy, popularly known as shock therapy, may cause stress and fear when you hear its name. However, It should be noted that, contrary to the common belief, ECT is a safe and effective way to treat depression and schizophrenia that have not responded well to common medications.

How is ECT performed?

In this method, certain parts of the brain are stimulated by small electrical waves. This stimulation is done by a professional and trained team, which also includes a psychiatrist.

When do we use ECT?

ECT is used when other treatments, such as medication and psychotherapy, have been ineffective in treating the disorder. In this situation, the patient is anesthetized by a specialist team before having an ECT.

What diseases and disorders can be treated by ECT?

The Food and Drug Administration (FDA) and the American Psychiatric Association have approved ECT for the following diseases and disorders:

People with the following conditions can also benefit from ECT:

  • Patients have not responded to medication and psychotherapy
  • Patients who are at high risk of suicide due to their illness
  • Patients who need immediate treatment
  • Pregnant women with severe mental illness
  • Elderly people with severe mental disorders

Research has shown that performing ETC is safer than medication for severe disorders in old age and during pregnancy.

Is ECT a definitive treatment?

Although ECT is a very effective method in the treatment of severe mental disorders, but we should know that it will not cause definitive treatment and eradication of the disorder. Many patients will need further treatment after ECT, including medication. These treatments may be therapy/psychotherapy or even re-ECT.

Benefits and risks of ECT:

Before performing ECT, the advantages and disadvantages of this method should be considered. For most patients with severe mental disorders, the risk of medication is higher than ECT. Especially when the patient is at risk of suicide or does not eat for reasons such as catatonia. In addition, when a patient is exposed to malnutrition and dehydration, the risk of continuing treatment with drugs will be very high.

What are the complications of ECT?

In ancient times, electroconvulsive therapy was performed without anesthesia, while today, before ECT, anesthesia consultation is performed by an anesthesiologist. Complications of ECT include a combination of anesthetic drugs and brain stimulation effects that would be transient. ECT can cause temporary memory loss and learning disabilities in the short term. Some patients may have difficulties in remembering the events that occurred in the weeks before the ECT treatment session. In most cases, memory impairment resolves within two months, but in some cases it may take longer.

The most common complications on the day of ECT are:

  • Headache
  • Fatigue
  • Confusion
  • Nausea
  • Mild memory loss (for example does not remember events close to therapy time).

These side effects may last for hours to days after ECT and usually resolve on their own.

Steps to perform ECT:

Prior to ECT, the patient undergoes a thorough examination of the body, a complete blood cell count, a chest radiograph and even an ECG. If the patient's illness is not very severe, before ECT, the doctor should discuss all the treatment conditions and their advantages and disadvantages with the patient and his family.

At each ECT session, the patient goes under general anesthesia, then the electrodes are attached to a specific part of the scalp, and the stimulation of the brain will be done by a short series of electrically controlled pulses. As a result, it improves mental disorders. The patient becomes conscious after about ten minutes without feeling anything from the treatment time.

How many sessions of ECT are needed?

The patient has two to three sessions of treatment per week for a total of six or twelve sessions. In general, the schedule and number of sessions depend on the severity of the disease and the rate of response to treatment. It should be noted that in extensive studies, ECT has been very effective for major depressive disorder and the disorder has been well controlled and treated in 80% of patients.

ECT emergencies:

One of the reasons for the emergence needs of ECT is in patients who are in the catatonic phase. Catatonic patients may not eat or drink water for many days and may also cause serious harm to themselves (such as amputation, removal of the eyeball, etc.)

Catatonic patients are very restless and dangerous in this phase. ECT is very important in the catatonic phase (which can lead to injury, malnutrition and dehydration).




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