Electroconvulsive therapy (ECT)

Despite all the rumours, ECT is an effective, quick and gentle treatment for depression and for some anxiety disorders when the patient is also depressed.

ECT is a safe treatment that can be used on both the elderly and on people who are suffering from heart disease or are otherwise frail.

Treatment

The ECT treatment always takes place in a hospital, often in a psychiatric ward. In most cases, you can receive ECT as an out-patient and go home on the same day.

One of the doctors on the psychiatric ward will give you the treatment. An anaesthetist will administer sedation and anaesthetic.  The number of treatments required very much depends on the individual.

You will be fully anaesthetised and given a muscle relaxing injection. A doctor then induces a convulsive fit by giving a weak electric shock over the side regions or over the right side region and the crown.

Only a very small part of the current from the electric shock reaches the brain. This activates the nerve cells, and if they are activated sufficiently, it triggers a convulsive fit.   This is a rhythmic, electric activity in the nerve cells which lasts for 25-60 seconds. As you are anaesthetized and completely relaxed, only small contractions in the muscles are noticeable.  It is this convulsive fit which causes the antidepressant effect. 

After the treatment, you rest for a short time while the nurses make sure that you have fully recovered.

Effectiveness and adverse effects

The beneficial effect of ECT usually begins after one or two weeks, whilst most medication takes two to four weeks to bring about a noticeable improvement of your symptoms.

ECT is safe and most patients don’t have any adverse effects at all.  However, a few patients do experience short-term memory loss after the treatment.  If you do have difficulty remembering events from the time during and around your ECT treatment, your memory should return to normal again after a few weeks.

You may perhaps be a little confused immediately after the treatment.  As with the memory function, confusion is only temporary, typically disappearing within a few hours.