What Is Electroconvulsive Therapy?

Electroconvulsive therapy (ECT) is an effective medical treatment for severe and persistent psychiatric disorders. It relieves de pressed mood and thoughts of suicide, as well as mania, acute psychosis, delirium, and stupor. It is usually applied when medications have given limited relief or their side effects are intolerable. Electroconvulsive therapy is similar to a surgical treatment. It requires the specialized skills of a psychiatrist, an anesthesiologist, and nurses. The patient receives a short-acting anesthetic. While the patient is asleep, the physician, following a prescribed procedure, induces an epileptic seizure in the brain. By making sure that the patient’s lungs are filled with oxygen, the physician precludes the gasping and difficult breathing that accompany a spontaneous epileptic fit. By relaxing the patient’s muscles with chemicals and by inserting a mouth guard (not unlike those used in sports), the physician prevents the tongue biting, fractures, and injuries that occasionally occur in epilepsy. The patient is asleep, and so experiences neither the painful effects of the stimulus nor the discomforts of the seizure. The physiological functions of the body, such as breathing, heart rate, blood pressure, blood oxygen concentration, and degree of motor relaxation, are monitored, and anything out of the ordinary is immediately treated. Electroconvulsive therapy relieves symptoms more quickly than do psychotropic drugs. A common course of ECT consists of two or three treatments a week for two to seven weeks. To sustain the recovery, weekly or biweekly continuation treatments, either ECT or medications, are often administered for four to six months. If the illness recurs, ECT is prescribed for longer periods. The duration and course of ECT are similar to those of the psychotropic medicines frequently used for the same conditions. Electroconvulsive therapy has been used safely to treat emotional disorders in patients of all ages, from children to the elderly, in people with debilitating physical illnesses, and in pregnant women. Emotional disorders may be of short or long duration; they may be manifest as a single episode or as a recurring event. Electroconvulsive treatment is an option when the emotional disorder is acute in onset; when changes in mood, thought, and motor activities are pronounced; when the cause is believed to be biochemical or physiological; when the condition is so severe that it interferes with the patient’s daily life; or when other treatments have failed.