Electroconvulsive therapy (ECT) is a safe and effective treatment for severe episodes of major depression, repeated suicide thoughts or attempts, mania, and some types of schizophrenia when all other measures of psychopharmacology and psychotherapies have been ineffective. It involves the use of a brief, controlled electrical current to produce a seizure within the brain. This seizure activity is believed to bring about certain biochemical changes that may cause symptoms to diminish or even disappear.
In addition to being referred by a physician or mental health professional, patients can self-refer for ECT. Patients who call speak with the ECT coordinator, a registered nurse, who takes preliminary information such as the patient’s condition and insurance to present to the doctor to determine whether they should be scheduled for an evaluation. Appropriate candidates for ECT are scheduled for an initial evaluation by an ECT-credentialed psychiatrist.
How ECT Is Administered
Prior to treatment, the ECT Department educates patients about the procedure and performs comprehensive psychiatric, medical, and laboratory evaluations to ensure that treatments are administered in the safest, most effective manner possible. ECT treatment can begin within five to seven days after the evaluations are complete. Patient consent (or consent by a legal guardian) is required for ECT treatment and the patient (or legal guardian) may withdraw consent at any time.
ECT is administered at CentraState Monday, Wednesday and Friday mornings. Patients are scheduled for treatment according to their needs for an average of six to 12 treatments on an inpatient or outpatient basis.
ECT is administered in a special treatment suite by a team of doctors with specialized training and experience. Medications that the patient is on prior to undergoing treatment may be adjusted to minimize the risk and maximize the effectiveness of treatment.
To view a short video about ECT produced by the Mayo Clinic, Click Here.
Effectiveness of ECT
Despite many recent advances in the treatment of mental disorders, ECT remains the most effective, fastest and/or safest treatment for some individuals. ECT is most useful in cases of major depression, where it produces strong beneficial results in 50 percent to 90 percent of patients. However, while a series of ECT treatments may bring an episode of illness to an end, it will not prevent another episode from occurring weeks, months or years later. Therefore, treatment plans generally consisting of medication, psychotherapy, or additional maintenance ECT (given as an outpatient at a much less frequent rate), may need to be considered.
Potential Side Effects of ECT
For most patients, ECT side effects are relatively minor. Headache, muscle soreness and nausea may occur but are usually mild and can be prevented or at least diminished by medications. The risk of death is very rare—about 1 per 10,000 patients for typical cases—but higher for those with some types of pre-existing medical problems.
Confusion and memory difficulties may also occur. ECT-related memory problems can be of two types: difficulty remembering new information, and a loss of some memories from the past, particularly the recent past such as during and just prior to receiving ECT. The ability to learn and remember new information returns to one’s usual level over a period of days to weeks after ECT. The ability to remember material from the past (prior to ECT) tends to return to normal over a similar time period, except that in this case, some memories from the recent past, mainly days to months prior to the treatments, may be delayed in recovery or even permanently lost. Patient surveys have reported longer gaps in memory. However, the surveys have indicated that most patients receiving ECT are not greatly disturbed by memory effects and would have ECT again if it was indicated.
The ECT Department is open Monday-Friday from 8 a.m. to 4 p.m. and can be reached at (732) 294-2884.