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Depression and Electroconvulsive Therapy

Read more about Electroconvulsive Therapy.

Overview

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Electroconvulsive therapy (ECT) is one of the oldest methods of depression treatment. Due to the discomfort experienced during therapy, ECT is often reserved for severely depressed patients who fail to respond to other treatment options or who are at immediate risk for suicide.

Effect of Electroconvulsive Therapy on Depression

In electroconvulsive therapy (ECT), electrodes are placed on either both sides of the head or at the front or back on one side of the head. Small electric currents are applied to the scalp to induce seizures. The mechanism by which ECT affects depression is still largely unknown.1

Treatment is usually done twice a week, or every other day, in a series of six to ten sessions. Notable improvements are expected to occur by the sixth or eighth session.1

Research Evidence on Electroconvulsive Therapy

Electroconvulsive therapy (ECT) was used since the 1930s to treat psychosis and major depression. When antipsychotic and antidepressant drugs were created in the 1950s and ‘60s, ECT became almost nonexistent. However, it made a comeback in medical treatment during the 19080s because of its effectiveness for some types of major depression unresponsive to medication.2

The American Psychiatric Association Task Force Report in 1990 has concluded that ECT is safe and effective for treating major depression.3 Some studies have found ECT to be more effective than pharmaceutical drugs for treating certain forms of severe depression. For psychotic depression, ECT was found to be twice more effective than antidepressant drug treatment.4

Side Effects and Warnings

Electroconvulsive therapy (ECT) can cause mild short term memory loss to severe and persistent memory loss.

ECT has a low rate of mortality. However, if you have cardiovascular problems, ECT is not recommended.

Unlike before the 1980s, anesthesia is now used in conjunction with ECT to minimize the physical reactions normally induced by seizures. The muscles are completely relaxed to inhibit convulsions during the procedure.

Other Uses

Psychosis, mania, rapid cycling bipolar disorder, schizophrenia, Parkinson’s disease

References

  1. DeBaffista, C. (1997). Medical Management of Depression. Durant: EMIS, Inc.
  2. Fink M: Convulsive Therapy: How it evolved. Psychopharm Bull 1986;22(2)
  3. American Psychiatric Association: The Practice of ECT: Recommendations for treatment, training, and privileging. Convulsive Therapy 1990; 6(2): 85-120.
  4. National Institute of Health Consensus Conference: Electroconvulsive Therapy. JAMA 1985; 254(15).

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