What is electroconvulsive therapy (ECT)?

Electroconvulsive therapy (ECT) is a medical procedure used to treat severe depression when other treatments, such as medication and psychotherapy, have been unsuccessful. It involves briefly sending electrical currents to the brain while you’re under anesthesia.

Although not without potential side effects, ECT has proven effective in rapidly reducing symptoms of severe depression. It may also be used for other psychiatric and neurological conditions.

Who is a candidate for ECT?

This treatment option is for people who are suffering with severe depression. It’s also sometimes used to treat symptoms of schizophrenia or Parkinson’s disease.

ECT may be considered if you have symptoms such as delusions, hallucinations or suicidal thoughts.

To be considered a candidate for ECT, you must undergo a thorough evaluation by a psychiatrist or mental health professional. This evaluation will assess your symptoms, medical history and overall health to determine if ECT is the most appropriate treatment option.

ECT is typically not recommended for individuals who have certain medical conditions, such as unstable heart disease or a history of seizures. It’s also usually not suitable for people who are pregnant or breastfeeding.

If you’re considering ECT, it is important to discuss the risks and benefits of the treatment with your doctor to determine if it’s the right choice for you.

What to expect during ECT

ECT treatments are usually performed two to three times a week over a period of two to three weeks. Maintenance treatments may be done once a week, tapering down to once a month. Maintenance may continue for several months up to a year, to reduce the risk of relapse.

For mental health conditions, ECT is usually given in conjunction with medicine, counseling or both.

Before your treatment

• You’ll be given anesthesia so you’ll be asleep during the treatment.
• You'll also receive medicine to relax your muscles.

During your treatment

• Electrodes will be placed on your temples or elsewhere on your head.
• A brief electrical current will be sent to your brain through the electrodes, causing a short seizure of up to eight seconds. ECT does not cause the body to convulse.

After your treatment

• You’ll likely experience some confusion, nausea, a headache or jaw pain after waking up. These effects should only last a few hours.
• You may also have short-term memory loss, which should improve within a few weeks.
• You’ll need to avoid driving until your doctor says it is safe.
• Long-term memory loss is also possible, although your memory may return over time.

In rare cases, ECT may increase blood pressure, cause changes in heart rhythm or produce seizures that last longer than expected. These physiologic changes typically occur immediately following the ECT treatment and can be managed by the health professionals doing the procedure, if needed. Often though, these changes resolve quickly without treatment.

The risks of untreated, severe depression are often greater than the risks of ECT.

Benefits of electroconvulsive therapy

If you're considering ECT, here are some of the potential benefits to keep in mind:

• Relief from severe depression: Studies have shown that ECT is an effective short-term treatment for severe depression, even in cases where other treatments have failed.
• Improved mood and energy: ECT can help alleviate the symptoms of depression, including feelings of sadness, hopelessness and fatigue. This can lead to a significant improvement in mood and energy levels, making it easier to engage in everyday activities.
• Reduced risk of relapse: Maintenance ECT can help reduce the risk of relapse in people who have experienced severe depression. This can provide long-term stability and prevent future episodes of depression.