Electroconvulsive Therapy (ECT)

Frequently Asked Questions about Electroconvulsive Therapy (ECT)

How does electroconvulsive therapy (ECT) work?

A brief electrical stimulation of the brain brings on a therapeutic seizure. It is believed that the seizure affects chemicals and neurons (cells that transmit information) in the brain. Studies show that it actually causes brain regrowth, and not damage to the brain as some people fear.

There still is more to learn about why ECT has a therapeutic effect. However, research shows that it helps between 70 and 90 percent of the patients who receive it.

Who is ECT recommended for?

ECT is prescribed for patients who have treatment-resistant depression, mania, or psychosis stemming from such conditions as major depression, bipolar disorder, schizophrenia, and schizoaffective disorder. Patients often have unsuccessfully tried several medications and may be suicidal. 

About 10 percent of the 14 million Americans who have depression are considered to have treatment-resistant depression, meaning that therapy and more than one medication regimen hasn’t helped them.

How is ECT administered?

A team consisting of an anesthesiologist, a psychiatrist, and nurses administers the treatment. The patient is sedated with general anesthesia and is given a muscle relaxant to keep him or her comfortable and unaware during the procedure. Electrodes are placed on the scalp, either on one or both sides of the head. Using paddles, a psychiatrist applies a carefully calibrated, brief current to the electrodes, bringing on a therapeutic seizure. 

The patient is awakened within 10 minutes and is taken to the post-anesthesia care unit to be monitored during recovery from the sedation. After about an hour, the patient is ready to leave.

How many treatments are needed?

A patient typically receives ECT two to three times a week for a total of six to 12 treatments. This may be followed by periodic maintenance treatments to reduce the chances of symptoms returning.

What are the benefits?

ECT relieves symptoms in as many as 90 percent of people who are living with treatment-resistant depression or other disorders.

For patients who are suicidal or experiencing such severe depression that they cannot care for themselves, medication would take too long to be effective. ECT provides rapid relief, often within the first week of treatments.

What are the risks?

Electroconvulsive therapy is an extremely safe procedure, with a risk of death somewhere around 1 in 50,000.

Side effects may include headaches, muscle pain, and nausea. ECT can affect the patient’s blood pressure and heart rate. All of these side effects can be managed with medications. 

After treatment, the patient may experience some confusion for a few minutes up to several hours. Loss of memories — whether recent or formed longer ago — is a notable side effect of ECT. However, memory problems usually lessen during the weeks after a treatment course. In addition, unilateral ECT (applied to only one side of the head) has been found less likely to cause memory issues.

The treatment also carries the typical risks associated with general anesthesia.

How effective is ECT?

Studies show that 70 to 90 percent of patients experience substantial improvement after ECT. The risk of relapse is less when patients have periodic follow-up (maintenance) treatments.