Electroconvulsive therapy, or ECT for short, has been known since the mid-1930s. It has proven to be highly effective and fast-acting, particularly for depression with delusional symptoms and depression that does not respond to medication or psychotherapy. In previously untreated patients, electroconvulsive therapy achieves remission rates of up to 90 percent. For patients who have not responded to attempts at treatment with medication, the remission rate is still between 50 and 75 percent.
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ECT (Electroconvulsive Therapy) - Further Information
What is electroconvulsive therapy (ECT)?
Electroconvulsive therapy (ECT) is a treatment method used for particularly severe and treatment-resistant cases of depression and schizophrenia. During ECT treatment, an epileptic seizure is induced under brief anesthesia using electrical impulses that last only a few seconds.
Electroconvulsive therapy device
Many people have preconceptions about electroconvulsive therapy, which are likely rooted in the fact that patients were once treated without anesthesia and the induced seizures sometimes resulted in serious injuries. Today, electroconvulsive therapy is a very gentle procedure performed under brief anesthesia and associated with only a few side effects.
How Electroconvulsive Therapy Is Performed
In electroconvulsive therapy, electrical stimulation of the temporal lobe—usually the right side—triggers an epileptic seizure that lasts about 30 to 60 seconds. Typically, 6 to 12 sessions are performed, usually at a rate of two sessions per week.
If unilateral treatments do not yield sufficient results, a few bilateral stimulation sessions may also be added.
Electroconvulsive therapy is performed under brief anesthesia and muscle relaxation. Due to the muscle relaxants, the epileptic seizure does not manifest as muscle twitching but occurs solely within the brain. There, it is made visible to the examiner through continuous recording of an electroencephalogram (EEG).
Side Effects of Electroconvulsive Therapy
Common and temporary side effects of electroconvulsive therapy include
- headaches,
- nausea,
- muscle soreness, and
- mostly mild disturbances in memory and recall
.
Before undergoing electroconvulsive therapy, comorbid conditions such as lung disease, high blood pressure, coronary heart disease, and cardiac arrhythmias must be well controlled to minimize the risks associated with anesthesia.
Follow-up Care After Completion of Electroconvulsive Therapy
After successfully completing a series of ECT sessions, the risk of relapse is high during the first few months. To reduce this risk, patients receive continued medication.
An alternative form of therapy, currently still in the trial phase, involves continuing the ECT series at longer intervals as maintenance ECT. For example, ECT treatments are repeated two to four times at weekly intervals, then at two-weekly intervals, and finally at monthly intervals.
Mechanism of Action of Electroconvulsive Therapy
Although it is known that ECT influences numerous metabolic processes in the brain, the exact mechanism of action of ECT remains unknown to this day.
