Electroconvulsive or electroconvulsive therapy, or ECT for short, has been known since the mid-1930s. It has proven to be very effective and fast-acting, particularly for depression with delusional symptoms and depression that does not respond to medication and psychotherapeutic treatment. In previously untreated patients, electroconvulsive therapy achieves improvement rates of up to 90 percent. In patients who have not responded to drug treatment attempts, the improvement rate is still 50 to 75 percent.
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Electroconvulsive therapy (ECT) - Further information
What is electroconvulsive therapy (ECT)?
Electroconvulsive therapy or electroconvulsive therapy is a treatment method that is used for particularly severe and treatment-resistant depression and schizophrenia. As part of ECT treatment, an epileptic seizure is triggered by electrical impulses lasting a few seconds under brief anesthesia.
Device for electroconvulsive therapy
Many people have prejudices against electroconvulsive therapy, which are probably due to the fact that patients used to be treated without anesthesia and the seizures triggered sometimes led to serious injuries. Today, electroconvulsive therapy is a very gentle procedure that is carried out under short anesthesia and is associated with only a few side effects.
Implementation of electroconvulsive therapy
In electroconvulsive therapy, an epileptic seizure is triggered by electrical stimulation of the right temporal lobe area, which usually lasts around 30 to 60 seconds. As a rule, 6 to 12 sessions are carried out, usually two sessions per week.
If the unilateral treatments are not sufficiently successful, several bilateral stimulations can also be added.
Electroconvulsive therapy is carried out under brief anesthesia and muscle relaxation. Due to the muscle relaxation, the epileptic seizure does not manifest itself through muscle twitching, but only takes place in the brain. There it is made visible to the examiner by continuously recording an electroencephalogram (EEG).
Side effects of electroconvulsive therapy
Common and temporary side effects of electroconvulsive therapy are
- Headaches,
- nausea,
- sore muscles and
- usually mild memory and retentive disorders have been described.
have been described.
Before electroconvulsive therapy is carried out, concomitant illnesses such as lung disease, high blood pressure, coronary heart disease and cardiac arrhythmia must be well controlled in order to minimize the risk of anaesthesia.
Follow-up treatment after completion of electroconvulsive therapy
After successfully completing a series of ECT, the risk of relapse is high in the first few months. To reduce this, patients receive further drug treatment.
An alternative form of therapy, which is currently still being tested, is to continue the ECT series at longer intervals in the form of maintenance ECT. For example, ECT treatments are repeated two to four times at weekly intervals, then at fortnightly 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 is still unknown.
