Electroconvulsive therapy Health Article

Electroconvulsive therapy

Eating disorders seeAnorexia nervosa and Bulimia nervosa

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Definition

Electroconvulsive therapy (ECT) is a medical procedure in which a small, carefully controlled amount of electric current is passed through the brainto treat symptoms associated with certain mental disorders. The electric current produces a convulsion for the relief of symptoms associated with such mental illnesses as major depressive disorder, bipolar disorder, acute psychosis, and catatonia.

Purpose

Also known as electroconvulsive shock therapy or electroshock therapy, ECT is used together with anesthesia, muscle relaxants and oxygen to produce a mild generalized seizure or convulsion. With repeated administration, usually over a period of weeks, ECT is highly effective in relieving symptoms of several mental illnesses.

The American Psychiatric Association's Practice Guidelines for the Treatment of Psychiatric Disordersdiscusses the use of ECT in the treatment of major depressive disorder, bipolar disorder and schizophrenia. Electroconvulsive therapy is administered to provide relief from the signs and symptoms of these and occasionally other mental illnesses. ECT is used routinely to treat patients with major depression, delusional depression, mania, and depression associated with bipolar disorder and schizophrenia. It is most closely associated with the treatment of severe depression, for which it provides the most rapid relief available as of 2002. In addition, patients suffering from catatonia, neuroleptic malignant syndrome, and parkinsonism may also benefit from the procedure.

ECT may become the treatment of first choice for depression if a patient with severe depression or psychotic symptoms is at increased risk of committing suicide and has not responded to other treatments. Although antidepressant medications are effective in many cases, they may take two to six weeks to begin to work. Some patients with mania and schizophrenia may not be able to tolerate the side effects of the antipsychotic medications used to treat these disorders. In addition, some patients may be unable to take their prescribed medications. For these individuals, ECT is an important option. ECT is also indicated when patients need a treatment that brings about rapid improvement because they are refusing to eat or drink, or presenting some other danger to themselves.

ECT is also recommended for certain subgroups of patients diagnosed with depression. Many elderly patients, for example, respond better to ECT than to antidepressant medications. Pregnant women are another subgroup that may benefit from ECT. Because ECT does not harm a fetus as some medications might, pregnant women suffering from severe depression can safely choose ECT for relief of their depressive symptoms.