Electroconvulsive therapy

MECTA spECTrum ECT machine

Bergonic chair for electroconvulsive therapy

ECT machine

ECT apparatus at NTM Eg Asyl

Electroconvulsive Therapy

Siemens konvulsator III (ECT machine)

Thymatron IV ECT machine

Electroconvulsive therapy (ECT), also known as electroshock therapy, is a psychiatric treatment that uses electrically induced seizures to alleviate the symptoms of certain mental illnesses. ECT is often employed when other treatments, such as psychotherapy and medication, have not been successful or are deemed unsuitable for the patient.

Indications

ECT is primarily used to treat the following conditions:

• Severe depression, particularly when accompanied by suicidal ideation or psychosis
• Treatment-resistant depression
• Acute mania in bipolar disorder patients
• Schizophrenia, when other treatments have been ineffective
• Severe cases of catatonia

Procedure

The ECT procedure typically involves the following steps:

• Preparation: Patients undergo a physical examination, blood tests, and an electrocardiogram (ECG) to assess their overall health and suitability for the procedure.
• Anesthesia: General anesthesia is administered to render the patient unconscious, and a muscle relaxant is given to minimize muscle contractions during the seizure.
• Electrode placement: Electrodes are positioned on one or both sides of the patient's head, depending on the type of ECT being administered (unilateral or bilateral).
• Electrical stimulation: A brief electrical current is passed through the brain, inducing a seizure that lasts for approximately 30-60 seconds.
• Recovery: Patients are monitored during the recovery period and usually regain consciousness within 5-15 minutes. They may experience temporary confusion, disorientation, or memory loss.

Effectiveness and side effects

ECT has been proven effective for many patients, with studies demonstrating significant improvements in depressive symptoms, mania, and catatonia.<ref>,

 Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis, 
 The Lancet, 
 
 Vol. 361(Issue: 9360),
 pp. 799–808,
 DOI: 10.1016/S0140-6736(03)12705-5,</ref> However, the treatment can also cause side effects, including:

• Short-term memory loss
• Long-term memory gaps
• Confusion
• Nausea
• Headaches
• Muscle aches

These side effects are usually temporary and resolve over time. The risk of complications can be minimized by following proper ECT protocols and adjusting treatment parameters to suit individual patients.

Ethical considerations

Informed consent is a crucial aspect of ECT administration, as patients must be fully aware of the potential risks and benefits of the treatment. Administering ECT without informed consent is considered medical abuse. Article 18 of the Yogyakarta Principles prohibits using any form of therapy, including ECT, to change a person's sexual orientation or gender identity.<ref>

The Yogyakarta Principles(link). Yogyakarta Principles.

Accessed 2021-09-30.

</ref>

See also

• Psychiatry
• Mental illness
• Depression
• Bipolar disorder
• Schizophrenia
• Catatonia
• Informed consent

External links

• National Institute of Mental Health: Brain Stimulation Therapies

Further reading

• The Effectiveness of Electroconvulsive Therapy: A Literature Review
• Electroconvulsive Therapy: A Modern Medical Treatment
• Controversies in the Use of ECT

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