What Is ECT?
Electroconvulsive therapy treatment (ECT) is a brain stimulation therapy performed by a physician, with the patient monitored closely in a pain-free environment.
At SUN Behavioral Houston, we constantly strive to make available to our patients clinically-proven, evidence-based care, whether it be through behavioral therapy, the aid of medications, or medically safe, sound procedures.
ECT Therapy: Who Should Receive It and Why?
Often, when a patient is experiencing mental health conditions, therapy and/or medication are the first course of treatment. If there are not the expected improvements to the patient’s disorder from these measures, ECT is a safe, effective option for a doctor to discuss with their patient.
ECT is most appropriate to consider for patients experiencing
- Medication-resistant depression
- Multiple hospital visits for the same mental disorder
- Multiple suicide attempts
How Is ECT Administered?
ECT is a medical procedure completed in a hospital environment that stimulates or hinders brain activity, either through electrodes or magnetic fields. The level of current is controlled and the patient experiences no discomfort, as they are under anesthesia during the procedure and receive muscle relaxants. It is typically administered through an initial series of procedures, then on a maintenance plan as needed.
The procedure itself lasts several minutes and can be done in a hospital environment or as an outpatient procedure. The procedures occur as part of a series, occurring twice a week and lasting between six and 12 sessions. Follow-up and medications may continue as determined between the patient and doctor.
History Behind ECT
ECT is the most studied therapy with over 75 years of peer-reviewed research indicating a 70%+ efficacy rate. Any controversy regarding ECT is typically based on unfamiliarity with its modern technique or memories from inaccurate depictions in fictional cinema.
According to The American Journal of Psychiatry Residents’ Journal, the first human trial was conducted in 1938 in Rome, Italy, on a man suffering from schizophrenia who was found roaming near a train station. He returned to his family after undergoing about 10 treatments and the scientific world turned its ever-inquisitive mind on the procedure to see if the success could be duplicated and how else it could be applied. Treatment time for the individual procedure was shortened and anesthesia was added in the early 1950s. Extending the time period of effectiveness and lowering the side effects are some of the current research focus.
ECT Benefits and Side Effects
Over 100,000 patients receive ECT in the United States, and 1 million people receive ECT worldwide annually.
According to Dr. Michael J. Barber, a Houston-based psychiatry specialist who is also the Medical Director for SUN Behavioral Houston’s ECT program, ECT is safe, effective, and has proven helpful for patients with severe depression who have not shown improvements with prescription medications.
ECT is shown to be effective, fast-acting, and requires treatments that will be maintained on an extended frequency after the initial series.
- Effective: With severe depression, the treatment works very well, making it the most effective treatment for severe depression. The Consortium for Research in ECT (CORE) and the Columbia University Consortium (CUC) concluded that ECT produced remission rates of 86% and 55% (more stringent remission criteria), respectively.
- Quick Acting: Patients may see a rapid response in as little as the first or second treatment of a series, whereas medication may take weeks to build in someone’s system. This could be devastating if the person is suicidal.
- Maintenance-Level Treatments: Treatment begins with a series of 10-12 treatments initially, with several treatments weekly until the series is complete. It may be followed by possible maintenance treatments that occur further apart in frequency. When the proper strategy has effective results, the patient will enjoy an improved quality of life. Work, school, and family responsibilities can be managed during continuing therapy sessions and medications.
Benefits often outweigh the side effects for patients, especially for those with severe depression not responsive to medicine. Quality of life can be improved. For those who turn to suicide attempts to escape their symptoms, ECT can be, in fact, truly life-saving.
Potential side effects*
Benefits may be short-lived with a maintenance treatment once a week for several weeks, then once every two weeks, and then once a month. Medication may still be needed.
- Temporary impairment of new memories or memories gained in the weeks prior, which will likely improve as more time passes between treatments. Most patients report no long-term issues.
- Headaches have been reported.
- Nausea may result.
- Muscle aches and soreness are possible.
- Short-term disorientation and confusion may occur.
Most of the physical side effects will improve following the second treatment. Patients should not drive immediately following treatment.
“I have performed thousands of treatments over the past 20 years and have seen firsthand the benefits. While it may seem like a scary procedure, it is important to realize that ECT is one of the safest procedures in all of medicine,” said Dr. Barber.
Dr. Barber and SUN Behavioral Houston work together and with the community to solve unmet needs. Having a mental disorder that is resistant to more common routes of treatment such as cognitive therapy or medication, can make a patient feel there are no other options for them. We want to show another way to regain quality of life for our patients and their families. Please reach out to us to learn more at 713-796-2273.
* As with any procedure involving general anesthesia, there is a remote possibility of death from ECT. The risk of death from ECT is very low, about 1 in 10,000 patients. This rate may be in patients with severe medical conditions.
In rare instances, ECT can result in serious medical complications such as heart attack, stroke, respiratory difficulty, or continuous seizure. Sometimes, ECT results in irregularities in heart rate and rhythm.