Electroconvulsive Therapy Overview

Electroconvulsive therapy machine

Nasko/Wikimedia Commons

Electroconvulsive therapy (ECT) is a form of psychiatric treatment that involves inducing seizures with the use of electrical stimulation while a patient is under general anesthesia. Originally known as electroshock therapy, ECT was first introduced by a pair of Italian psychiatrists in 1938. However, the use of induced seizures to treat mental illness dates back as far as the early 1500s.

It became a popular psychiatric technique during the 1940s and 1950s, particularly in the treatment of severe depression. Stigma attached to the use of ECT led to a decline in its use during the 1960s. The emergence of effective psychiatric medications to treat depression also contributed to its decline.

Today, electroconvulsive therapy is still used as a treatment for cases of treatment resistant depression and some other psychiatric conditions including bipolar disorder and psychosis, although its use remains controversial.

Statistics

  • Approximately 70% of ECT patients are women.
  • One study found that 42.8% of people who had ECT achieved remission of depressive disorder symptoms.
  • Memory loss is one of the most commonly reported side effects of ECT.
  • An estimated one million people worldwide have ECT each year.
  • Between 1975 and 1980, there was a 46% decline in ECT use in the United States.
  • ECT use remained steady throughout the 1980s and even began to rise through the next decade.
  • More than a third of ECT patients are age 65 and older.
  • Use in children and teens remains relatively rare. Some states, including Colorado and Texas, prohibit the use of ECT in children and adolescents under the age of 16.

Effectiveness

While the use of ECT remains controversial, many recent studies and literature reviews suggest that it can be a safe and effective treatment, particularly in the case of severe depression.

By 1941 electroconvulsive therapy (ECT) was used by nearly half of the mental health institutions in the United States. ECT has been found effective for some patients who are unresponsive to other therapies, including antidepressant drugs.

One way to decrease the possibility of brain damage in the areas of stimulation is to use it minimally only when other treatment methods have failed.

The evidence supporting the efficacy of ECT in depression is overwhelming. In several studies, ECT was found to be far more effective than other methods. There is still a significant stigma attached to its use, so it is used sparingly.

Side Effects

Side effects from ECT include memory loss (often short-term but sometimes permanent), fractured bones, headaches, and even death. Serious complications do exist, particularly the risk for permanent brain damage.

Research suggests that ECT can be a safe and effective procedure to treat depression, psychosis, catatonia, and suicidality. Several treatments may be needed to see a lasting effect. 

Before undergoing ECT, talk with your doctor to make sure you have exhausted other options and to discuss your risks.

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