ECT (Electro Convulsive Therapy) is a treatment for severe episodes of major depression, mania, and some types of schizophrenia. 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 changers which may cause your symptoms to diminish or to even disappear. A series of seizures, generally 4-‐12, given at a rate of two or three per week, is required to produce such a therapeutic effect. Sometimes a smaller or larger number may be necessary.
ECT works by affecting the same transmitter chemicals in the brain that are affected by medications. Although there have been many advances in the treatment of mental disorders in recent years, ECT remains the most effective, fastest and/or safest treatment for many cases, particularly when alternative treatments, usually medications are either not effective or not safe, or when a person is very likely to commit suicide. Your doctor will discuss with you why ECT is being recommended in your case and what alternative treatments may be available. ECT is most effective in major depression, where it has a strong beneficial effect to patients. Still there is no guarantee that ECT, or for that matter, any treatment will be effective.
All treatments have risks and side effects; however, not treating your depression also carries potentially significant risks. Prior to ECT patients will undergo a careful medical, psychiatric and laboratory evaluation to make sure that the treatments can be administered in the safest, most effective manner possible. Medications may be adjusted to minimize the risk and maximize the effectiveness of the treatments. For most patients the side effects of ECT are relatively minor.
An overall assessment of the nation’s largest real-world study of treatment –resistant depression (STAR*D, funded by NIMH) suggests that a patient with persistent depression can get well after trying several treatment strategies, but his or her odds of beating the depression diminish as additional treatment strategies are needed.
The results show that 50% of patients fail to achieve remission from depression despite four phases of sequenced treatments. However, ECT provides a 50% to 60% response rate in patients who have not responded to one or more adequate antidepressant trials. (Prudic et al. 1996; Sackeim et al. 1990, 2000).
ECT General Overview Video
ECT Technical Overview Video