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.
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
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Problems with thinking and memory that may go away in a couple of weeks or may last for many months
- Short-term changes in heart rhythm
- Long-lasting seizure
- Heart attack or cardiac arrest
Things that may raise the risk of problems are:
- A history of heart problems, stroke, or high blood pressure
- Pregnancy
- Increased age
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before ECT
- Fasting before ECT, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from ECT
- Specialists you may need to see
- Tests that will need to be done, such as an ECG or brain scans
Anesthesia
General anesthesia will be used. You will be asleep.
Description of Procedure
A guard may 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. Some muscles will contract for a few seconds after the shock is given. Next, the body will twitch, which can last up to a minute.
Most people need 2 to 3 treatments per week for many weeks. Some may need ongoing treatments to prevent symptoms from returning.
Immediately After Procedure
You will be taken to a recovery room where your vital signs will be watched. You will wake up in 10 to 15 minutes. You may feel confused. This confusion can last minutes, hours, or sometimes longer.
How Long Will It Take?
About 30 minutes
Will It Hurt?
A headache and muscle aches are common in the first hour after the test.
Average Hospital Stay
Most people go home the same day. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Care Center
The staff will give you something to eat and drink when you are fully awake.
At Home
ECT may result in memory loss. Some memories may return in a few weeks while other memories may not return at all. Activities like driving and making important decisions may need to be limited during recovery. You may also need to delay return to work.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Symptoms that worsen, such as feelings of hopelessness or helplessness and thoughts of suicide
- 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 medical help 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 (ECT). Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/how-electroconvulsive-therapy-works. Accessed November 23, 2020.
Electroconvulsive therapy (ECT). Mental Health America website. Available at: http://www.mentalhealthamerica.net/ect. Accessed November 23, 2020.
Electroconvulsive therapy (ECT) for depression. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/electroconvulsive-therapy-ect-for-depression. Accessed November 23, 2020.
Ottosson JO, Odeberg H. Evidence-based electroconvulsive therapy. Acta Psychiatr Scand. 2012 Mar;125(3):177-184.
Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 4/14/2021