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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 last resort 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 often is 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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