Electroconvulsive therapy is a treatment that changes the brain’s electrical activity to help regulate neurotransmitter levels. It is used to manage conditions such as depression, schizophrenia, and other mental health disorders.
Also known as electroshock therapy or ECT, this treatment is considered safe and effective. It is performed under general anesthesia, which prevents pain and reduces physical risks during the procedure.
Although electroconvulsive therapy can significantly reduce symptoms, it does not cure the underlying condition. Treatment is usually done in a series of sessions based on a psychiatrist’s recommendation.
When it is indicated
ECT may be recommended in the following situations:
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Major depression
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Bipolar disorder
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Schizophrenia
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Catatonia
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Parkinson’s disease
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Tourette syndrome
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Obsessive-compulsive disorder (OCD)
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Epilepsy
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Severe mental illness during pregnancy when medications are not recommended
ECT may also be used to treat schizoaffective disorder or when medication is not suitable. This is more common in pregnant individuals, those who are breastfeeding, or older adults.
How it works
ECT is performed in a hospital and typically lasts up to 30 minutes. The procedure does not cause pain or discomfort because the person is under general anesthesia.
Before the procedure, fasting for at least 7 hours is required. Muscle relaxants are also given to prevent physical reactions during the treatment.
During ECT, a controlled electrical stimulus is delivered through two electrodes placed on the front of the head. This stimulus triggers a brief seizure that is monitored on an electroencephalogram.
The electrical activity helps regulate neurotransmitters such as serotonin, dopamine, norepinephrine, and glutamate. This process can reduce symptoms linked to mood and psychotic disorders.
After the procedure, the care team monitors the person until they are stable. Treatment usually involves 6 to 12 sessions, and progress is evaluated after each session by a psychiatrist.
How it was done in the past
In the past, electroconvulsive therapy was used not only for treatment but also in harmful ways. It was sometimes applied without proper medical standards.
The procedure was not performed under anesthesia, and muscle relaxants were not used. This led to strong body movements, fractures, and memory loss.
Over time, the technique has improved significantly. Today, ECT is considered safe, with a low risk of complications, and seizures are only detected through monitoring equipment.
Possible complications
ECT is generally safe, but some temporary side effects may occur. These can include confusion, short-term memory loss lasting less than 60 minutes, or general discomfort after the procedure.
Other mild effects may include headache, nausea, muscle pain, or aspiration pneumonia. These symptoms are usually short-lived and can be treated with appropriate medications.
When it is not indicated
Electroconvulsive therapy can be used in most people when medically appropriate. However, certain conditions require careful evaluation before proceeding.
These include increased intracranial pressure, brain tumors, pheochromocytoma, cerebral aneurysm, vascular malformations, or a recent stroke or heart attack within the past 3 months.