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Electroconvulsive therapy

Shock treatment; Shock therapy; ECT; Depression - ECT; Bipolar - ECT

Electroconvulsive therapy (ECT) uses an electric current to treat depression and some other mental illnesses.

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Description

During ECT, the electric current triggers a seizure in the brain. Doctors believe that the seizure activity may help the brain "rewire" itself, which helps relieve symptoms. ECT is generally safe and effective.

ECT is most often done in a hospital while you are asleep and pain free (general anesthesia):

Why the Procedure Is Performed

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

Less often, ECT is used for conditions such as mania, catatonia, and psychosis that DO NOT improve enough with other treatments.

Risks

ECT has received bad press, in part because of its potential for causing memory problems. Since ECT was introduced in the 1930s, the dose of electricity used in the procedure has been decreased significantly. This has greatly reduced the side effects of this procedure, including memory loss.

However, ECT can still cause some side effects, including:

Some medical conditions put people at greater risk for side effects from ECT. Discuss your medical conditions and any concerns with your doctor when deciding whether ECT is right for you.

Before the Procedure

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

Ask your provider whether you should take any daily medicines in the morning before ECT.

After the Procedure

After a successful course of ECT, you will receive medicines or less frequent ECT to reduce the risk of another depression episode.

Outlook (Prognosis)

Some people report mild confusion and headache after ECT. These symptoms should only last for a short while.

References

Siu AL; US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for depression in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(4):380-387. PMID: 26813211 www.ncbi.nlm.nih.gov/pubmed/26813211.

Welch CA. Electroconvulsive therapy. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 45.

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Review Date: 7/8/2018  

Reviewed By: Ryan James Kimmel, MD, Medical Director of Hospital Psychiatry at the University of Washington Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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