Electroconvulsive Therapy (ECT): Definition, Types, Techniques, Effectiveness

Definition:

Electroconvulsive therapy (ECT) is a psychiatric treatment that involves inducing a seizure with electrical stimulation while the patient is under anesthesia. ECT is sometimes used as a "last resort treatment" for select severe mental illnesses when other treatments have failed.

Types of ECT:

There are three general types of ECT:

• Bilateral ECT: Electrodes are placed on both sides of the head to stimulate the entire brain.

• Unilateral ECT: Electrodes are placed on one side of the head to stimulate only one hemisphere of the brain.

• Ultrabrief pulse (UBP) ECT: Electrodes are placed on one side of the head, and a brief (less than one millisecond), high-intensity electrical pulse is delivered. UBP ECT is thought to have fewer side effects than traditional ECT.

Techniques:

ECT is typically performed in a hospital or clinic setting. The patient is given a muscle relaxant and anesthesia to prevent movement and pain. Before the procedure, the patient undergoes a thorough assessment to determine the appropriate treatment parameters, including electrode placement and electrical stimulation. Electrodes are placed on the scalp, and a brief electrical pulse is delivered to the brain. The electrical pulse causes a seizure lasting about 30 seconds.

Effectiveness:

ECT has been shown to be an effective treatment for severe depression and other mental illnesses. A review of studies found that ECT was effective in reducing depression symptoms in approximately 80% of patients. Additionally, ECT has demonstrated effectiveness in treating bipolar disorder, schizophrenia, catatonia, postpartum depression, and severe agitation or psychosis unresponsive to other therapies.

Benefits of ECT:

• Rapid onset of action
• High effectiveness rate

Side Effects of ECT:

ECT can cause a range of side effects, including:

• Memory loss, especially for events that occurred shortly before or after the treatment.
• Confusion
• Nausea
• Headache
• Muscle pain
• Increased risk of cardiovascular complications, such as heart attack or stroke

Things to Consider Before Undergoing ECT:

Before considering ECT, a patient should:

• Discuss the risks and benefits of ECT with their doctor.
• Ensure that they have tried other treatments that have not been effective.
• Be aware that ECT is not a cure for mental illness, and that they may need ongoing treatment after ECT.

How to Get Started:

If you think ECT might be helpful, talk to your doctor. Your doctor will perform a thorough evaluation to determine if ECT is right for you. This evaluation may include a physical exam, a psychiatric evaluation, and blood tests.

If you are a candidate for ECT, your doctor will provide you with more information about the procedure and its risks and benefits. You will also need to sign a consent form before ECT can be performed.