What is ECT?
Electroconvulsive Therapy (ECT) is a safe and effective medical treatment for certain psychiatric disorders. ECT is also called "electrical stimulation of the brain", "electroshock therapy" or "shock therapy".
ECT has been used to treat many psychiatric disorders since 1938. Since then, the technique has been improved to increase its effectiveness and reduce its side effects. The patient undergoing ECT first undergoes a series of blood tests, a heart X-ray, brain electrocardiogram and MRI.
Internal medicine, anesthesia and neurology specialists assess whether anesthesia and ECT are appropriate,
How is ECT administered?
In an emergency treatment room with an anesthesiologist and a psychiatrist present, the patient lying on a stretcher is first given anesthesia drugs to induce muscle relaxation and sleep.
Then, two electrodes placed on the patient's forehead deliver an electric current for a few seconds. With this current, a rhythmic electrical activity occurs in the brain and brain chemicals are released. The procedure lasts about 5 minutes, after the end of the procedure, the treatment team is with the patient for about 15-20 minutes while the patient is fully awake.
Does ECT cause brain damage?
There is no scientific evidence that ECT causes brain damage. In patients undergoing ECT, no increase in enzymes and proteins in the bloodstream has been observed in case of brain damage. In animal experiments, no damage was observed in the brain tissue examined after seizures triggered by ECT, and no structural changes were observed even months after the seizure. The increase in brain temperature during ECT is about one tenth of a degree, so the electricity does not damage brain tissue.
Does ECT cause permanent memory loss?
Memory deficits after ECT usually disappear completely within a year. ECT does not reduce the ability to learn, on the contrary, it makes learning easier as the depression disappears. However, in some patients, it may take 6 months to 1 year to recall personal memories immediately before ECT. Forgetfulness in psychiatric patients, however, is more likely to be caused by an under-recovered illness, medication side effects or aging.
With the availability of newer medications, the need for ECT has decreased, but ECT is still the most effective treatment for a large number of patients. In some cases, the response to medication is inadequate, in others the desired dosage cannot be increased due to side effects, and in some cases the patient is at risk of suicide, which is why ECT is the only way to achieve rapid improvement.
How many ECTs are used for treatment?
ECT is usually administered 2-3 times a week. The general practice is 6-12 ECTs in one course.
Is ECT a safe treatment?
A study conducted in the USA in 1999 found that there was one death per 50,000 ECT treatments, which is much lower than the incidence of maternal death in childbirth. Other studies have found similar rates of death from heart attacks and other causes in depressed patients with and without ECT. With modern anesthesia techniques, ECT has become even safer.
Is ECT painful for the patient?
There is no similarity between the scenes of ECT or the electric chair in the movies and the actual ECT procedure. ECT is not painful, it is not a punishment for the patient. Most patients who have undergone ECT have found sitting in the dentist's chair more stressful than ECT.
Does ECT cure?
In 90% of patients who undergo ECT, some improvement is observed. Many patients remain well for months after ECT. After ECT, treatment is usually continued with medication. However, some mental illnesses may not be completely cured despite strong treatment. In this case, the aim is to achieve the best possible and most functional state for the patient.
In which diseases can ECT be applied?
The most common condition for which ECT is used is severe depression. In this illness, the person experiences intense sadness, grief, loss of attention, disturbances in appetite and sleep, and may have suicidal thoughts. ECT can also be used in mania and schizophrenia.
What are the side effects of ECT?
During the first hour of waking up after ECT, the patient may experience a state of confusion and inability to recognize his/her surroundings. In the first months, there may be mild difficulty in remembering details of recent events, dates, phone numbers. However, this condition gradually disappears over the months. The effect of ECT is independent of forgetfulness. ECT is not a memory erasure technique. With the new devices we use in our clinic, the duration of the electric current used in the treatment has been shortened and this side effect has been minimized.
