Electroconvulsive therapy (ECT) is a procedure in which a brief application of electric current to the brain, through the scalp, induces a seizure. It is typically used to treat a patient who is suffering from severe depression.

Why is ECT used?

ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients, in patients who suffer from mania, and in other mental illnesses. ECT is generally used as a later treatment option when severe depression is unresponsive to other forms of therapy, or when the patient is so ill that his or her life is in danger. It also is used when these patients pose a severe threat to themselves or others, and it is dangerous to wait until medications take effect.

How is ECT performed?

Prior to ECT treatment, a patient is put to sleep using general anesthesia, and a muscle relaxant is given. ECT causes the patient to have a seizure. Electrodes are placed on the patient’s scalp and a finely controlled electric current is applied, which causes a brief seizure in the brain. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet.

Patients are carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and may feel confused. This confusion typically lasts for only a short period of time. ECT is given up to three times a week for 2 to 4 weeks.

A course of ECT is usually followed by psychotherapy and medicine under a psychiatrist's care.

ECT: A controversial treatment

ECT remains the most controversial treatment for psychiatric illness, although it has been used since the 1940s and 1950s. Many of the risks and side effects have been related to the misuse of equipment, incorrect administration, and improperly trained staff. There also is a misconception that ECT is used as a "quick fix" instead of long-term therapy or hospitalization. Unfavorable news reports and media coverage have added to the controversy of this treatment. In fact, ECT is safe and among the most effective treatments available for depression.

Making an informed decision about ECT

Before ECT is considered, you should discuss all available treatment options for your condition with your doctor. If ECT is recommended, you should receive a complete medical examination including a history, physical, neurological exam, ECG (heart test), and lab tests. Your medication history should be carefully evaluated and monitored.

If you are considering ECT as a treatment option, be advised that it may provide temporary improvement but has a high relapse rate. Many doctors advocate follow-up treatment that includes medicine or ECT given at less regular intervals, called "maintenance ECT." Short-term memory loss is the major side effect, although this usually goes away 1 to 2 weeks after treatment.

You should be educated and informed about ECT and any treatment prior to receiving it. Ask for educational literature, videos, and an honest discussion with your doctor about the potential benefits and side effects.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/13/2014...#9302