What Is Electroconvulsive Therapy & Is It Effective?

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Electroconvulsive therapy (ECT) is a medical treatment that involves electrically stimulating the brain. It is used for specific mental health disorders, including severe forms of major depressive disorder and bipolar disorder, that do not respond to other treatments like medication and therapy.

Read on to learn more about the uses, benefits, and side effects of ECT.

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Uses for ECT

Medication and therapy are first-line treatments for most mental health conditions, but when a disorder or illness does not respond to treatment, a healthcare provider may recommend considering ECT.

The following are some uses for ECT:

  • Severe depression and treatment-resistant depression
  • Depression with psychosis
  • Severe bipolar disorder
  • Acute states of mania with bipolar disorder
  • Schizophrenia
  • Severe catatonia
  • Suicidal patients who are unable to wait for antidepressants to take effect

How Often Is ECT Used?

Every year, ECT is administered in hospitals and psychiatric hospitals to an estimated 100,000 people. ECT is one of the oldest brain stimulation therapies. It was first used in the 1940s for severe mental illnesses and today is typically used when other therapies are not effective.

Benefits of ECT

One benefit of ECT is speed, in that it can work more quickly than medication.

For example, it can take time (up to four weeks) for anti-depressants to start taking effect in the body and balance the brain's chemistry. ECT can begin working immediately.

Another benefit of ECT is that is an alternative to medication. This can be helpful for patients who experience difficulty with side effects from their medications.

Side Effects of ECT

ECT, like many medical procedures, does involve some risks. There are risks with general anesthesia as well as the procedure itself. However, in some cases, the risk of untreated illness is riskier than ECT.

Some of the side effects of ECT include:

  • Headaches
  • Muscle pain
  • Nausea
  • Confusion
  • Memory loss
  • Difficulty learning
  • Cognitive effects

What to Expect

Typically before having ECT, a patient will need a complete psychiatric assessment and medical exam. It's also important to check heart health with tests such as an electrocardiogram to make sure the heart can handle the procedure.

An important part of the process is informed consent, which requires making sure the patient knows what they are consenting to with the ECT procedure. In the event a person is unable to make decisions for themselves, some states may appoint a court-appointed guardian.

ECT Stigma

ECT is one of the oldest psychiatric treatments but has also been one of the most controversial. In movies and media, it is often depicted as an unfavorable treatment, both frightening and threatening, which has created a stigma.

For many years, ECT was not as highly regulated as it is today. Today's ECT is a much more comfortable procedure known as modified ECT. There is also significant evidence-based medical research indicating effectiveness. Most importantly, informed consent is a vital and essential part of the procedure.

The ECT Procedure

With ECT, the brain is briefly stimulated with electrodes to trigger a controlled seizure. The treatment affects the brain chemistry and balance of neurons and chemicals in the brain.

A patient typically receives a total of six to 12 treatments based on the severity of symptoms.

At the start of the procedure, the patient is given a muscle relaxant and put under general anesthesia by a healthcare provider or anesthesiologist, so they are asleep and unable to feel any pain during the procedure.

Electrodes are attached to the scalp, and the brain is then stimulated with a brief and controlled series of electrical impulses. This causes the brain to have a controlled, general seizure that occurs for about a minute.

The patient usually awakens around five to 10 minutes after the procedure.

Results With ECT

ECT is considered the most effective treatment for severe, untreatable depression. In cases of major depressive disorder and bipolar depression, remission is achieved in about 50% of cases. In depression with psychotic features, remission rates range from 63% to as high as 95%.

Generally, some patients require fewer treatments than others to reach remission. For patients with bipolar depression, multiple studies indicate that fewer ECT sessions were needed to put it into remission.

Summary

Electroconvulsive therapy, or ECT, is a medical treatment that involves electrically stimulating the brain with electrodes to prompt a general seizure. This impacts the neurochemicals of the brain. It has been found to be a safe and effective treatment for treatment-resistant depression and bipolar disorder, as well as other mental health disorders not responding to medication and therapy.

A Word From Verywell 

While ECT is a safe and effective treatment, it is not a cure. Medication and therapy are often still needed. If you are suffering from a severe mental illness that is not responding to traditional treatments, speak with your healthcare provider about the risks and benefits of ECT.

Frequently Asked Questions

  • Is electroconvulsive therapy painful?

    While today's ECT procedures are designed to be as comfortable as possible with muscle relaxants and general anesthesia, some people do report headaches, muscle aches, and pain after the procedure at the stimulation spot where the electrodes were placed.

  • What is electroconvulsive therapy most commonly used to treat?

    ECT is most commonly used to treat severe, treatment-resistant major depression, severe bipolar disorder, or with patients who are at high risk for suicide and cannot wait the length of time it takes for anti-depressants to begin working.

  • Who should not undergo electroconvulsive therapy?

    ECT treatment is not for everyone. People with heart conditions or those who cannot undergo general anesthesia or take muscle relaxants are not good candidates for the procedure. While some studies show it can be effective in children with treatment-resistant depression and other mental health disorders and illnesses, it is not commonly used for children. Some states prohibit the use of ECT in children under the age of 16.

  • How long does it take to see results from ECT?

    One study indicated that for bipolar depression, ECT offers a fast response, usually within several weeks. Some studies indicate it can take up to six treatments to start seeing results. However, ECT usually responds more quickly than the time it takes medications, such as antidepressants, to begin fully working. For patients at high risk of suicide, ECT is considered to be an effective treatment because the results are quicker than medications.


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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Mental Health America. Electroconvulsive therapy (ECT).

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