Electroconvulsive Therapy (ECT) is recognized by the National Institute of Mental Health as a successful treatment option for severe depression, bipolar disorder and schizophrenia. Today, as many as 100,000 people in the United States receive ECT each year to treat these illnesses.
Clinical and technical improvements in ECT have resulted in more effective treatments with fewer side effects, and we’ve found that ECT can work faster than psychiatric medications or psychotherapy, helping when other treatments have failed, providing dramatic, life-saving results.
ECT is most commonly indicated for people with severe depression, bipolar disorder and schizophrenia that haven’t improved with medications or other treatment modalities. Patients with these illnesses may experience sadness, despair, difficulty concentrating, loss of appetite and inability to sleep. They may also have suicidal tendencies.
The ABCs of ECT
A small intravenous (IV) catheter is inserted in the patient’s arm or hand by a registered nurse or anesthesiologist. An anesthetic is given through the IV, along with a strong muscle relaxant. These general anesthetic agents allow the patient to drift gently off to sleep. A mouth guard is used to protect one’s teeth and tongue. While asleep, a small, precisely calculated dose of electricity is delivered between two electrodes to induce a closely monitored seizure. The patient wakes up after approximately 10 to 15 minutes without discomfort or memory of the treatment. The patient is then carefully observed in the recovery room until discharge. Under normal circumstances, the entire procedure lasts from two to two-and-a-half hours from admission to discharge.
ECT Side Effects
It is common for patients to experience some confusion immediately after an ECT treatment. A patient may wake up and not remember where he or she is or why he or she is receiving ECT. This generally lasts from a few minutes to several hours. Often patients describe their thinking as “hazy” or “clouded.” This typically goes away when the course of treatment is completed. Many patients experience temporary loss of recent or remote memories with ECT, especially with bilateral ECT. Doctors may use special techniques (such as right unilateral ECT) to minimize effects on memory. In most patients, memory disturbances usually resolve within a few days or weeks, but occasionally may continue in a mild form for a period of months or even longer. Other common side effects that may occur on the days a patient has an ECT treatment are nausea, headache, muscle aches or jaw discomfort. These side effects can be effectively treated with medications to lessen them or alleviate them completely.
How Many Treatments, How Often?
A patient usually receives an ECT treatment two to three times a week for a total of six to twelve treatments. ECT is an exceptionally effective medical treatment, helping 90 percent of patients who receive it. Most patients remain well for many months after a treatment course, however, monthly or bimonthly maintenance treatments are also an option to maintain disease remission.
How Does ECT Work?
It is still not completely understood how ECT helps treat mental illnesses. It is known, however, that many neurochemical changes occur during and after seizure activity. It is theorized that when ECT is administered on a regular basis, these neurochemical changes build upon one another and reduce the symptoms of the mental illness.
Despite its unpopular past, electroconvulsive therapy is now a safe and effective treatment for severe depression, bipolar disorder and schizophrenia. ECT can work faster than psychiatric medications or psychotherapy can, and it can help when other treatments have failed. It is also safe for elderly patients and pregnant patients. Our experienced team of psychiatrists, anesthesiologists and registered nurses has received extensive specialized training in electroconvulsive therapy in order to provide our patients with the very best care in a safe, compassionate environment.
At Rolling Hills Hospital, ECT is performed on both an inpatient and outpatient basis. Referrals for ECT may be made via the ECT Fast Track process. For more information, please contact ECT Charge Nurse Jan Daniels, R.N., at 615-628-5743.