Carl R. Darnall Army Medical Center - Health Library

Electroconvulsive Therapy

(Therapy, Electroconvulsive; ECT)

Definition

Electroconvulsive therapy (ECT) sends an electronic current through the brain. This current causes brief seizure activity. This causes changes in brain chemistry.

The Brain
Color coded brain

During ECT, an electronic current is delivered to the brain.

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Reasons for Procedure ^

ECT is used to treat mental health problems such as:

Possible Complications ^

Your doctor will review possible problems such as:

  • Problems with thinking and memory—most go away in a couple of weeks, but for some, these may last for many months
  • Short-term changes in your heartbeat
  • Headache
  • Nausea
  • Muscle aches or soreness

Rarely:

Your chances of having problems is higher for:

  • A history of heart problems, stroke, or high blood pressure
  • Pregnancy—may increase the risk of problems for the baby
  • Taking medicines that haven't helped you
  • Increased age

What to Expect ^

Prior to Procedure

You may have:

  • A physical exam
  • To talk about all the medicines you're taking
  • Some tests such as an ECG to test your heart or brain scans
  • Instructions on food or drink limits before the procedure

You may feel confused after ECT. Arrange for a ride and for help at home.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of Procedure

Oxygen is given through a mask. A mouth guard may also be placed in the mouth. This will protect the tongue and teeth from getting hurt. Next, electrodes will be placed on the head. They will be hooked up to a machine. It will send an electric current to the brain. This will cause a seizure. After the shock is given, some muscles will contract for a few seconds. Next, the body will twitch, which can last up to a minute.

Immediately After Procedure

You will be taken to a recovery room where your vital signs will be watched. You will wake up in 10-15 minutes. You may feel confused. This confusion can last minutes, hours, or sometimes longer.

How Long Will It Take?

About 30 minutes, including time to recover after the procedure

How Much Will It Hurt?

You will not feel any pain during the procedure. After ECT, you may have a headache, and muscle aches or soreness.

Post-procedure Care

At the Care Center

When you are fully awake, you will be given something to eat and drink. In most cases, you will be able to go home the day of the procedure.

At Home

You will need to schedule an appointment for another ECT treatment. In most cases, you will need to have 2-3 treatments per week, for many weeks. You will need to take medication, such as antidepressants, and continue with therapy to prevent a relapse.

You may also need maintenance ECT to further prevent a relapse. Your doctor will help determine the right plan for you. This will depend on how you are progressing.

Call Your Doctor ^

Call your doctor if you have any of these:

  • Worsening of symptoms, including feelings of hopelessness or helplessness and thoughts of suicide—If you have thoughts of suicide, call your doctor or therapist right away.
  • Confusion and memory loss that lasts longer than expected.
  • Headache, muscle aches, or soreness that lasts longer than expected.

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Psychiatric Association
https://www.psychiatry.org

Mental Health America
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
https://www.cpa-apc.org

REFERENCES:

Electroconvulsive therapy. El Camino Hospital website. Available at: http://www.elcaminohospital.org/Programs_and_Services/Behavioral_Health/Electroconvulsive_Therapy. Accessed September 4, 2018.

Electroconvulsive therapy (ECT). Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/how-electroconvulsive-therapy-works. Updated May 22, 2017. Accessed September 4, 2018.

Electroconvulsive therapy (ECT). Mental Health America website. Available at: http://www.mentalhealthamerica.net/ect. Accessed September 4, 2018.

Electroconvulsive therapy (ECT) for depression. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T361082/Electroconvulsive-therapy-ECT-for-depression. Updated August 23, 2018. Accessed September 4, 2018.

Kellner CH, Greenberg RM, Murrough JW, et al. ECT in treatment-resistant depression. Am J Psychiatry. 2012;169(12):1238-1244.

5/13/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T361082/Electroconvulsive-therapy-ECT-for-depression: Semkovska M, McLoughlin DM. Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis. Biol Psychiatry. 2010;68(6):568-577.

Last reviewed June 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 9/4/2018