What are possible side effects of electroconvulsive therapy (ECT)?

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.
Side effects of today’s electroconvulsive therapy (ECT) treatment are well understood and mostly time-limited. There is a period of disorientation immediately after the therapy; this usually resolves over the course of the day, Randall Espinoza, M.D., M.P.H., medical director of the Electroconvulsive Therapy Program at the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA, explains.

In addition, two main types of memory problems are associated with ECT. Anterograde amnesia, or the inability to create new memories, is common during the initial treatment phase but generally ceases to be a problem once the ECT stops, and it resolves by about two to three months. By contrast, a degree of retrograde amnesia -- the inability to recall information from the past -- occurs in most patients as they complete their initial phase of treatment; it can take six to 12 months to dissipate, although 25-30 percent of patients continue to report memory gaps after a year.

“Importantly, if these patients have responded to ECT and are no longer depressed, they do not find this type of memory loss functionally impairing,” 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. “And increasingly we recognize that many of the persisting memory problems ECT patients report are actually related to the depressive illness itself.”

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