How does electroconvulsive therapy (ECT) work?

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.”

The specific reason for the positive action of ECT is unknown. There are multiple theories to explain why ECT is effective. One theory suggests that the seizure activity itself causes an alteration of the chemical messengers in the brain known as neurotransmitters. Another theory proposes that ECT treatments adjust the stress hormone regulation in the brain, which may affect energy, sleep, appetite and mood.

  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments.
  • ECT may cause some side effects, including confusion, disorientation and memory loss. Usually these side effects are short term, but sometimes they can linger.

A patient is put under brief anesthesia and given a muscle relaxant. He or she sleeps through the treatment and does not consciously feel the electrical impulses or feel pain. Within 1 hour after the treatment session, which takes only a few minutes, the patient is awake and alert.

Some people experience memory loss and confusions as a side effects, but those are usually for a short period of time.

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