Electroconvulsive therapy

• Alternative Names

  Shock treatment; ECT

• How the test is performed

  Electroconvulsive therapy (ECT) is most often done in a hospital's operating or recovery room while you are asleep and pain-free (general anesthesia).

  • You receive medicine to relax you (muscle relaxant) and to prevent you from feeling pain (short-acting anesthetic).
  • A small amount of electric current is delivered to the brain to cause seizure activity. It lasts for about 40 seconds. Medicine is given to prevent the seizure from spreading throughout the body.
  • ECT is usually given once every 2 - 5 days for a total of 6 - 12 sessions.
• How to prepare for the test

  Because general anesthesia is used for this procedure, you will be advised to not eat or drink before ECT.

  Ask your health care provider whether you should take any daily medications in the morning before ECT.

• How the test will feel

  Some people report mild confusion and headache after ECT. Hospital staff will monitor you closely after the procedure to make sure that you recover completely.

• Why the test is performed

  ECT is a highly effective treatment for depression, most commonly severe depression. It can be especially helpful for treating depression in patients who:

  • Cannot take antidepressant drugs
  • Are suicidal
  • Are pregnant and severely depressed
  • Have certain heart problems
  • Are psychotic

  It is also used to treat bipolar disorder, people who are rigid and not responsive (catatonic), and some psychotic disorders.

• What the risks are

  Possible side effects from ECT include:

  • Allergic reaction to the anesthesia
  • Headache
  • Low blood pressure (hypotension)
  • Memory lapses
  • Rapid heartbeat (tachycardia)
  • Temporary confusion
• Special considerations

  Some medical conditions place patients at greater risk for side effects of ECT. Discuss any such conditions or concerns with your health care provider when deciding whether ECT is right for you.

• References

  Frederikse M, Petrides G, Kellner C. Continuation and maintenance electroconvulsive therapy for the treatment of depressive illness: a response to the National Institute for Clinical Excellence report. J ECT. 2006;22:13-17.

  Kellner CH, Knapp RG, Petrides G, et al. Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE). Arch Gen Psychiatry. 2006;63:1337-1344.

  Institute for Clinical Systems Improvement. Health Care Guideline: Major Depression in Adults in Primary Care. 10th ed. May 2007.

Review Date: 8/24/2008

Reviewed By: Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.