What Is ECT?
Electroconvulsive Therapy (ECT) is a safe and effective medical treatment for certain psychiatric disorders. ECT is also known as “electrical stimulation of the brain,” “electroconvulsive therapy,” or “shock therapy.”
ECT has been used to treat many psychiatric disorders since 1938. Since then, this technique has been refined to increase its effectiveness and reduce its side effects. Before ECT is administered, he undergoes necessary blood tests, an electrocardiogram (ECG), an electroencephalogram (EEG), and an MRI.
Specialists in Internal Medicine, Anesthesiology, and Neurology evaluate whether there are any contraindications to anesthesia and ECT administration.
How is ECT administered?
In a treatment room equipped for emergency intervention and staffed by an anesthesiologist and a psychiatrist, the patient, lying on a stretcher, is first administered anesthetic medications that induce muscle relaxation and sleep.
Next, an electric current is delivered for a few seconds through two electrodes placed on the patient’s forehead. This current induces rhythmic electrical activity in the brain and triggers the release of brain chemicals. The procedure lasts approximately 5 minutes; afterward, the treatment team remains with the patient for about 15–20 minutes until the patient is fully awake.
Does ECT cause brain damage?
There is no scientific evidence that ECT causes brain damage. In patients who have undergone ECT, no increase in enzymes or proteins—which would indicate brain damage—has been observed in the bloodstream. In animal studies, no damage was observed in brain tissue examined after ECT-induced seizures, and no structural changes were observed even months after the seizure. The increase in brain temperature during ECT is only one-tenth of a degree; therefore, the electrical current does not damage brain tissue.
Does ECT cause permanent memory loss?
Memory impairments observed after ECT generally resolve completely within one year. ECT does not impair learning ability; on the contrary, it facilitates learning by alleviating depression. However, in some patients, it may take between 6 months and 1 year to recall personal memories from the period immediately before ECT. Nevertheless, forgetfulness in psychiatric patients is more frequently observed due to an insufficiently resolved illness, medication side effects, or aging.
With the availability of new medications, the need for ECT has decreased; however, it remains the most effective treatment for a large number of patients. In some cases, the response to medication is inadequate; in others, the desired dose cannot be reached due to side effects; and in certain situations—such as when the patient is at risk of suicide—rapid improvement, which only ECT can provide, is sought.
How many ECT sessions are required for treatment?
ECT is typically administered 2–3 times per week. The standard course of treatment involves 6–12 ECT sessions.
Is ECT a safe treatment?
A 1999 study conducted in the U.S. found that there was one death out of 50,000 ECT treatments, a rate significantly lower than the rate of maternal mortality during childbirth. Other studies have also found that the rates of death from heart attacks and other causes are similar among patients with depression who receive ECT and those who do not. With modern anesthesia techniques, ECT has become even safer today.
Is ECT painful for the patient?
There is no resemblance whatsoever between the ECT scenes depicted in movies or images of the electric chair 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 a dentist’s chair to be more stressful than ECT.
Does ECT help?
A certain degree of improvement is observed in 90% of patients who undergo ECT. Many patients maintain their improved state for months after ECT. Treatment following ECT is typically continued with medication. However, in some mental illnesses, complete recovery may not be achieved despite intensive treatment. In such cases, the goal is to ensure the patient achieves the best possible state and the highest level of functioning.
For which conditions is ECT used?
The most common condition for which ECT is used is severe depression. In this condition, the person experiences intense sadness, grief, loss of concentration, and disturbances in appetite and sleep, and may have suicidal thoughts. ECT can also be used for mania and schizophrenia.
What are the side effects of ECT?
Upon waking after ECT, the patient may experience a gradually subsiding state of disorientation and difficulty recognizing his surroundings for the first hour. In the first few months, there may be mild difficulty recalling details of recent events, dates, and phone numbers. However, this condition gradually subsides and disappears over the course of several months. The effectiveness of ECT is independent of any memory loss. ECT is not a memory-erasing technique. With the new devices we use at our clinic, the duration of the electrical current used in treatment has been significantly reduced, minimizing this side effect.
