Electroconvulsive therapy (ECT) is the gold standard for treatment of severe depression, and other psychiatric disorders, by inducing changes in brain chemistry that can rapidly reverse symptoms. As one of the oldest and most widely used mental health procedures, ECT often works when other treatments are unsuccessful. ECT is an extremely effective form of treatment. It is often safer and more effective than medications or no treatment at all. If you have any questions about ECT, please discuss them with your psychiatrist.
If you and your psychiatrist feel that ECT is a good option for you, please have your psychiatrist fill out the ECT referral form and fax to (513) 558-0877. You can also call us at (513) 558-7700 to schedule a consultation appointment.
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Frequently Asked Questions
What is ECT?
Electroconvulsive therapy (ECT) is an extremely safe and effective medical treatment for certain psychiatric disorders. ECT has been used for over 60 years. In the United States, about 100,000 individuals are estimated to receive ECT each year.
Who should receive ECT?
ECT is most commonly given when patients have severe depressive illness, mania or some forms of schizophrenia. ECT is often given when patients have not responded to other treatments, when other treatments appear to be less safe or difficult to tolerate, when patients have responded well to ECT in the past, or when psychiatric or medical considerations make it particularly important that patients recover quickly and fully.
If you have any questions about ECT, please discuss them with your psychiatrist. If you and your psychiatrist feel that ECT is a good option for you, please call us to schedule a consultation appointment.
What have patients said about ECT?
One survey found that following ECT, most patients reported it was no worse than going to the dentist and many even found ECT less stressful. Many psychiatric illnesses result in impairment of attention and concentration. Consequently, when psychiatric disturbance improves following ECT, a vast majority of patients report improvement in these aspects of thinking. They also report that if needed, they would receive ECT treatment again.
How is ECT given?
With this treatment, a small amount of electricity is applied to the scalp and produces a seizure in the brain. Because the patient is asleep under general anesthesia, the procedure is virtually painless.
When the patient comes to the ECT treatment room, an intravenous line is started. Sensors for recording brain activity, heart rate and blood pressure are administered. An anesthetic medication is injected that will cause the patient to sleep for 5 to 10 minutes. Once the patient falls asleep, a muscle relaxant is injected. This prevents movement during the seizure and minimal contractions of the muscles.
When the patient is completely asleep and the muscles are well relaxed, a brief electrical charge is applied to electrodes on the scalp. This stimulates the brain and produces a seizure that lasts for about a minute. Throughout the procedure, the patient receives oxygen through a mask. When the treatment is completed, the patient is taken to a recovery area and is monitored by trained staff. Usually within 30 to 60 minutes, the patient can leave the recovery area.
How many treatments are needed?
ECT is given as a course of treatments. The total number needed to successfully treat psychiatric disturbance varies from patient to patient. For depression, the typical range is from 6 to 12 treatments, however some patients may require more or less depending on their individual circumstances.
How safe is ECT?
ECT is often recommended for patients with serious medical conditions because of its strong safety record. ECT appears to have less risk of death or serious medical complications than a number of other medications used to treat psychiatric conditions.
What are the common side effects of ECT?
The patient will experience some confusion upon awakening following the treatment which typically clears within an hour. Headaches are possible following the treatment but can be relieved by acetaminophen or ibuprofen. Other side effects, such as nausea, last for a few hours at most and are relatively uncommon. In patients with heart disease, there may be an increased risk of cardiac complications. Cardiac monitoring and other precautions, including the use of additional medications if required, help to ensure a safe treatment.
ECT may result in memory loss. Two types of memory loss have been reported. The first involves rapid forgetting of new information. For example, shortly following the treatment, patients may have difficulty remembering conversations or things they have recently read. This type of memory loss is typically short-lived and has not been shown to persist for more than a few weeks following the completion of ECT. The second type of memory loss involves events from the past. Some patients will have gaps in their memory for events that occurred in the weeks to months, and less commonly years, prior to the treatment course. This memory loss also typically reverses following the completion of ECT. However, like with any treatment, patients differ in the extent to which they experience side effects, and more extensive memory loss has been reported by a minority of individuals. Scientifically conducted patient surveys have indicated that most patients receiving ECT are not greatly disturbed by memory effects and would have ECT again if it was felt to be indicated.
Does ECT cause structural damage to the brain?
Brain imaging studies following ECT have shown no damage in the structure or composition of the brain. The amount of electricity used in ECT is so small that it cannot cause electrical injury.
What is the difference between TMS and ECT?
TMS and ECT are both procedures that treat major depression. The important differences between TMS therapy and ECT include:
• ECT requires anesthesia whereas TMS does not
• ECT applies electrical energy to the whole brain, while TMS uses magnetic energy applied only to the left prefrontal cortex
• TMS therapy is a non-invasive procedure that does not require anesthesia and does not produce a seizure
With any treatment, patients and clinicians should work together to determine the most appropriate option.