Electroconvulsive Therapy To Treat Mental Illness
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Electroconvulsive therapy (ECT) affects brain chemistry associated with depression by applying a small amount of electrical energy to the brain to induce a brief seizure—without associated body convulsions.
"The best analogy is to rebooting a computer,” says Randall Espinoza, MD, MPH, medical director of the Electroconvulsive Therapy Program at the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA. “When a computer freezes, you have to reboot the system, and that is essentially what electroconvulsive therapy (ECT) is doing for a person who is in a state of depression.”
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Side effects from electroconvulsive therapy (ECT) can include:
- Memory loss (usually temporary). Most patients have some memory loss, mostly for information and events around the time of the ECT series. The more ECT treatments you have, the stronger the memory loss may be. Memory loss is usually temporary, lasting several days or weeks before memory returns. Some loss can be permanent, especially for events surrounding the time of ECT. Rarely, patients have extensive and prolonged memory loss (around 1 in 200 patients). Do not make important decisions or sign legal contracts until you are cleared to do so by your doctor.
- Muscle soreness, headache, or nausea, usually lasting less than 48 hours. If these side effects occur, they can be treated with medication.
Risks and potential complications of ECT are described below.
Problems caused by anesthesia:
- The anesthesia can inhibit the reflexes that keep stomach contents from reaching the throat, wind pipe, or lungs. If this happens, it can block your breathing or cause pneumonia. To prevent this, do not eat or drink anything after midnight the night before an ECT treatment.
- Anesthesia can cause a serious allergic reaction. Tell the doctor about any medication allergies you have.
Problems caused by the procedure:
- In rare cases, a heart rhythm problem can occur. In extremely rare cases (fewer than 1 in 10,000 patients), this can be fatal.
- Despite muscle relaxant medication, muscle contractions can sometimes happen. In very rare cases, they can be strong enough to fracture a vertebra (bone in your spine) or other bone.
- Tooth damage can occur. It is important to tell your doctor about any loose teeth, loose caps, bridges, dentures, or other dental appliances.
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Early administration of ECT involved high doses of electricity given without anesthesia or muscle relaxation; this application produced significant side effects, both cognitive and physical. While the therapy has not been applied that way since the mid-1950s, Randall Espinoza, M.D., M.P.H., medical director of the Electroconvulsive Therapy Program at the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA, says misconceptions persist.
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Electroconvulsive therapy (ECT) is used when medications are too risky because of a medical condition (like for some women who are pregnant), or when other medications and therapy have failed to relieve symptoms.
If medications and other therapies have not worked to treat your bipolar symptoms or you are concerned about complications with a medical condition you have, talk to your doctor about whether ECT is a viable option for you.
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What is Electroconvulsive Therapy (ECT)?
Electroconvulsive Therapy (ECT), formerly known as shock therapy, may be one of the most misunderstood therapies available to treat severe depression. This kind of therapy is sometimes use when psychotherapy and medication is not effective.
Generally, it is used with patients who experience treatment-resistant depression, patients who suffer from depression and mania, or suicidal patients.
ECT has improved since the 1940s and 1950s when it became controversial based on stories of its misuse in the media.
During ECT treatment, a patient receives a muscle relaxant and anesthesia. Electrodes then are affixed at specific placements on the head. The electrodes deliver electrical impulses of about 30 seconds, causing a seizure within the brain. The treatment generally is given three times per week for several sessions.
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Before electroconvulsive therapy or ECT for depression, you will need to have a psychiatric evaluation and a physical exam. This is to make sure ECT is the right -- and safe -- choice for you. You will likely also have a blood test and an echocardiogram ("echo"). An echo is done to make sure your heart is healthy and that ECT will not be risky for your heart.
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Electroconvulsive therapy (ECT) may sometimes offer rapid relief for some people with schizophrenia. For instance, if a person with schizophrenia is actively suicidal, ECT may reduce this tendency. It can also help to reduce symptoms such as hallucinations and delusions. ECT is a therapy used to alter the chemistry of people's brains. In decades past, ECT caused injuries, brain damage, and other serious side effects. Today, ECT is considered safe and offers help for some people when no other treatments are working. ECT does come with some risks, including:
• Loss of memory
• Nausea and vomiting
• Aches and pains
• Confusion
• Other medical problems, like increasing heart rate and blood pressure
People who receive ECT are usually unconscious, under general anesthesia. After two or three treatments that last less than 15 minutes each, many people with schizophrenia notice an improvement in their symptoms.
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Scientists do not know exactly how electroconvulsive therapy (ECT) helps people with schizophrenia. According to the Mayo Clinic, ECT changes the brain chemistry in people with schizophrenia. During ECT, a person is sedated under general anesthesia. Electrodes are placed onto the person's scalp, and electrical currents pass through the electrodes into the person's brain. When ECT is performed, the person will have a brain seizure, causing brain chemical changes to take place. Since schizophrenia is caused by changes in brain functioning, ECT can be helpful to reduce some symptoms of the illness in a short amount of time. Over time, and with repeated sessions, ECT can reduce symptoms of severe mental illness.
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Electroconvulsive therapy (ECT) is a safe treatment for people with schizophrenia. During ECT, electrodes on the scalp send an electric current to the brain, causing a seizure. This treatment is mostly helpful for people who are not responding to other standard schizophrenia treatments, such as antipsychotic medications and psychosocial therapies. While historically ECT might have resulted in injuries, procedures are now performed under anesthesia with a muscle relaxant, which lowers the risk for injuries. However, there are still risks for complications. On occasion, people who receive ECT notice temporary memory problems after treatment. Others may experience body aches or pains. ECT requires the use of general anesthesia, which may increase one's risk of complications.
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For the most part, electroconvulsive therapy (ECT) is a safe and effective medical procedure used to treat schizophrenia. Like most medical procedures, ECT can produce some undesirable side effects. One of these side effects is that people may react to the anesthesia used in the procedure. People who have heart trouble may face an increased risk of complications from elevated heart rate and blood pressure. Another side effect that may be worrisome is memory loss. According to the National Institute of Mental Health, if ECT is performed only on one side of the brain, instead of both sides, this side effect may be reduced. People who receive ECT treatment may feel confused or disoriented for a few minutes or hours after the procedure. This side effect mostly occurs for older people and varies considerably from person to person.
