Behavioral Health and Psychiatry

Electroconvulsive Therapy

Behavioral Health and Psychiatry

Electroconvulsive therapy, or ECT, is a safe and effective evidence-based medical treatment used to help patients with certain psychiatric and neurological illnesses. It was first used in the 1930s, before alternate treatments were available. Today’s ECT bears little resemblance to earlier forms of the procedure, thanks to advances in technology and anesthesia.

ECT is endorsed as a valuable tool in the treatment of certain psychiatric disorders by the National Institute of Mental Health, American Psychiatric Association, American Medical Association, and U.S. Surgeon General.

Appointments and Referrals

For additional information on electroconvulsive therapy at Englewood Health, call 201-894-3142 or 201-894-3959. If you or a loved one is experiencing a psychiatric emergency, call 911.

What is electroconvulsive therapy (ECT) used to treat?

ECT is used to treat:

  • severe depression
  • mania
  • catatonia (when someone is extremely immobilized or extremely excited, either of which condition can be life threatening)
  • schizophrenia
  • Parkinson’s disease when symptoms of depression or psychosis are present
  • postpartum depression or depression in pregnant women

This type of therapy is usually considered only if a patient’s illness has not improved after other treatments (such as antidepressant medication or psychotherapy) are tried, or in cases where rapid response is needed (as in the case of suicide risk and catatonia, for example).

What are the benefits of ECT?

ECT has the highest rates of response and remission, compared with other forms of antidepressant treatment. Although ECT may not benefit everyone, those with depression usually respond significantly faster to ECT than to antidepressants.

What are the risks or side effects of ECT?

The most common side effects associated with ECT include headache, upset stomach, muscle aches, and memory loss. Some people may experience memory problems, especially of memories around the time of the treatment. Sometimes the memory problems are more severe, but usually they improve over the days and weeks following the end of an ECT course. Risks and side effects of ECT should be discussed with your physician.

What are the steps in the evaluation process?

  • An evaluation by a psychiatrist who specializes in ECT.
  • A complete medical workup, including but not limited to, a physical examination, laboratory tests, electrocardiogram, and other diagnostic tests.
  • An informed consent, which reviews the potential benefits, risks, side effects, possible complications of the treatment during the procedure and recovery period, risks of doing nothing, as well as possible alternative treatments, will be obtained by the psychiatrist. The individual may withdraw consent at any time.

What happens during the procedure?

Before the procedure:

  • No food or liquids are permitted after midnight the evening before treatment.
  • The patient is sedated with general anesthesia including a muscle relaxant to prevent movement during the procedure. An anesthesiologist, certified registered nurse anesthetist, and recovery room nurses monitor breathing, heart rate and blood pressure during the entire procedure. The procedure is conducted by a trained medical team, including physicians and nurses.

During the procedure:

  • Small electrodes are placed at precise locations on the head.
  • Through the electrodes, an electric current passes through the brain, causing a seizure that lasts generally less than one minute.
  • Because the patient is under anesthesia and has taken a muscle relaxant, it is not painful and the patient cannot feel the electrical impulses.
  • Five to ten minutes after the procedure ends, the patient awakens. He or she may feel groggy at first as the anesthesia wears off. But after about an hour, the patient usually
    is alert and can resume normal activities, except driving.
  • The entire procedure usually takes less than 30 minutes.

How many treatments are necessary?

  • Each person is different, but the initial series typically consists of 6-12 treatments, administered three times a week.
  • A person may require 20 or more treatments.
  • As long as a person is improving, treatments should continue until the maximum benefit is reached.

What is maintenance ECT?

  • After the initial series is completed, maintenance treatments are recommended for six months or longer, to prevent relapse.
  • The schedule may vary. For example, maintenance treatments may begin weekly and decrease to monthly, depending on the severity of the illness and the likelihood of relapse.
  • The goal is to provide the fewest treatments necessary to maintain health.
  • Frequently, a person who undergoes ECT also takes antidepressant medication or a mood stabilizing medication.

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