Electroconvulsive Therapy (ECT): Details and Negative Effects
Depression affects approximately 350 million people worldwide, making it the leading global cause of disability.1 Only 60-70% of persons with major depressive disorder who take antidepressant medications will respond to medication therapy. The remainder will become treatment resistant.
Electroconvulsive therapy (ECT), indicated for people with treatment-resistant depression, is really a safe, medically controlled procedure by which a tiny bit of electric energy is undergone the mind to be able to result in a brief seizure.
ECT is given under anesthesia both in outpatient and inpatient hospital configurations. It offers rapid improvement and remission of depressive signs and symptoms in 60-90% of individuals who undergo treatment.
ECT has additional signs to treat individuals really ill with mania, psychosis, catatonia, irritated dementia, posttraumatic stress disorder (Post traumatic stress disorder), with people who’re suicidal. The most typical side-effect of ECT is temporary loss of memory.
Contents of this article:
- What is ECT?
- How ECT works
- What to expect from ECT
- Side effects of ECT
You will also see introductions at the end of some sections to any recent developments that have been covered by MNT‘s news stories. Also look out for links to information about related conditions.
Fast facts on ECT
Here are some key points about ECT. More detail and supporting information is in the main article.2-4
- The American Psychiatric Society (APA) has established clear guidelines for ECT use.
- ECT is a safe treatment for pregnant women, adolescents, and elderly individuals.
- Positive results can be seen in as few as one to two ECT treatments.
- Approximately, 100,000 persons annually receive ECT in the United States.
- 70% of ECT patients are women.
- ECT is used to bring people out of catatonia (awake but unresponsive to surroundings).
- ECT costs approximately $1,500 per individual treatment and is covered by most insurance companies.
- The overall symptom remission rate after ECT is between 60-90%.
- There are over 100 ECT clinics across the United States.
- ECT is done under anesthesia by a specially trained physician.
- ECT can help certain medical conditions such as Neuroleptic Malignant Syndrome (NMS), essential tremors, delirium, chronic pain syndromes, and Parkinson’s disease.
- There is no reliable evidence of any long-term harmful effects of ECT.
What is ECT?
Electroconvulsive therapy (ECT), formerly called electroshock therapy, has been used to treat several psychiatric conditions since the early 20th century.
Electroconvulsive therapy is used for individuals with treatment-resistant depression.
In the early use, it wasn’t uncommon for individuals going through treating suffering bone fractures, teeth damage, and significant pre-treatment anxiety. The therapy methods enhanced, and ECT had maximum good response.
Using ECT dropped considerably within the 1960s as antidepressants and antipsychotic medications grew to become available.
Despite its effectiveness and unequalled safety record, lots of people opposed its use and recklessly pictured ECT as dangerous. Subsequently, the general public grew to become frightened of the process and attached an undeserved stigma to the use.
Today’s overwhelming evidence shows ECT is really a valuable, frequently underutilized treatment that may bring remission or management to individuals long lasting serious psychological illnesses.5
How ECT works
Electroconvulsive therapy delivers a small electric pulse to the brain while an individual is under general anesthesia.
With ECT, an electric charge is delivered to the brain and causes a seizure, which helps relieve the symptoms of depression.
This will cause cognitive abilities to fireplace in symphony, which creates a brief seizure. Since the individual finding the treatments are asleep as well as their muscles relaxed, the seizure is just apparent through the brain’s wave activity located on a monitor.
The main reason ECT works is unknown.
It’s thought that the electrical pulse causes an instantaneous rise in dopamine and serotonin, your body’s primary neurotransmitters connected with depression.
ECT also leads to a discharge of important the body’s hormones, in addition to our natural mood-elevating chemicals referred to as hormones.
Antidepressants have the identical action, although it takes several days and often different medication combinations to get exactly the same effect.6
On the next page we look at what to expect from electroconvulsive therapy and the possible side effects of the treatment.
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What to expect from ECT
Electroconvulsive therapy remedies are carried out on either an inpatient or outpatient facility with a specifically trained physician.
People are known to ECT by their mental health specialist or any other healthcare specialist. The ECT provider then meets the individual to ensure the therapy is warranted. A person’s all around health will be evaluated, and also the informed consent process is begun.
Family involvement is encouraged to help the patient understand information about ECT, and to learn how best to care for their family member during the span of treatment. The consultation also serves as an opportunity to correct misperceptions about ECT.
The informed consent process for ECT is much more detailed than most dental and medical methods.
Family people stay carefully involved throughout the ECT treatment course, with updates around the progress of treatment and then any negative effects. The person receiving treatments are involved in most making decisions regarding any alterations in or termination from the treatment.7
Finally, the person will come across by having an anesthesiologist and get a screening background and physical with a medical specialist. For convenience, they are frequently completed on the day that because the first ECT treatment.
Based on pre-existing health conditions, other screening tests for example ECG, and choose bloodstream work will be performed and evaluated just before beginning treatment. An dental exam is completed in advance through the anesthesiologist, and then any pre-existing loose teeth or any other dental issues ought to be addressed accordingly.
The anesthesia is shipped with an IV. When the patient is underneath the results of muscle relaxer and anesthesia, the electrical pulse is given through electrode pads put on either temple. This whole process lasts under a few minutes where heartbeat and rhythm, bloodstream pressure, temperature, and bloodstream oxygen levels are carefully supervised. The individual spends as much as an hour or so in recovery, so when fully awake can leave the ability. No driving is permitted for twenty-four hrs after.
Side effects of ECT
Electroconvulsive therapy is well tolerated, and there are no absolute contraindications to the treatment. It may even be given to women during pregnancy as well as adolescents.
Memory loss is the primary side effect associated with ECT treatment. Most people experience retrograde amnesia, which is a loss of memory of events leading up to and including the treatment itself.
The greatest side-effect of ECT may be the potential lack of recollections experienced just before, and soon after undergoing treatment. This side-effect is exclusive to every individual, and may potentially persist for a lot of several weeks following treatment.8
The reason behind this side-effect would be that the area of the brain that retrieves recollections is basically impacted by the electrical stimulation. However, experienced practitioners can lessen this side-effect by individualizing the therapy, and modifying certain things for example lead positioning, kind of anesthesia, and also the time interval between remedies.
Within the U . s . States, ECT is usually given three occasions per week, usually on the Monday, Wednesday, Friday schedule, along with a treatment cycle is between nine to 12 remedies.
Other part effects can include headache, confusion, nausea, and muscle aches. Seniors patients could see more unsteadiness and also have a rise in falls. Discomfort relievers and anti-nausea can automatically get to help lessen these undesirable effects.
Complications of ECT are rare, and generally not life threatening. As with any procedure done under anesthesia, there is a risk of serious heart problems or other reaction to anesthesia.
Safeguards ought to be drawn in patients with certain or unstable health conditions (recent cardiac arrest, nuclear physics or mind injuries, chronic obstructive lung disease, bronchial asthma, stroke, or pneumonia).9 Medical clearance with a specialist might be needed.
ECT is indicated for people who’ve a serious acute psychological illness, or treatment-resistant depression. Lack of knowledge and myths regarding ECT treatment has led to the underutilization through the medical community.
Regrettably, many practitioners don’t consider referral for ECT until many several weeks or many years of medication along with other therapy failures, departing an individual in great suffering and not able to operate to have an extensive time period.
Prolonged depressive episodes along with other acute psychological illness can result in greater treatment resistance and also at worst, dying by suicide.
Electroconvulsive therapy is an efficient low-risk treatment option that needs to be went after for select people struggling with a number of hard to treat mental health insurance and brain related disorders.
Recent developments on ECT from MNT news
New strategy to severe depression with far less negative effects
Electroconvulsive therapy remains probably the most effective remedies for severe depression, but new UNSW studies have shown ultra-brief pulse stimulation is nearly competitive with standard ECT, with far less cognitive negative effects.
Electroconvulsive therapy changes key regions of a persons brain that lead to memory and emotion
A small group of UCLA scientists have proven the very first time inside a large cohort of patients that electroconvulsive therapy (ECT), sometimes known to as shock treatment, change many places from the brain that lead to how people feel, learn and react to good and bad ecological factors.