What Are the Pros and Cons of Electroconvulsive Therapy for Depression?

Electroconvulsive therapy for depression (ECT) might provide an immediate improvement in symptoms, making it advantageous for patients who cannot use certain drugs. This therapy might help people who are severely depressed and suicidal, and patients unresponsive to other treatment. Electroconvulsive therapy for depression might cause memory loss going back a few weeks or years. Confusion is another common side effect of shock therapy that may last several days.

Mental health experts use electroconvulsive therapy for depression as a last resort when other therapy fails to help a patient. If a patient is so severely depressed that he or she loses touch with reality, shock treatment might help. Without treatment, the depressed person might enter a psychotic state.

Electroconvulsive therapy for depression might reverse longstanding symptoms when medication and psychiatric therapy proves ineffective. It has been used on pregnant women who risk harm to an unborn child if certain drugs are ingested. This form of treatment might also be effective for elderly patients unable to tolerate medication used to treat serious depression.

ECT earned a negative reputation because early procedures involved high doses of electrical current without anesthesia. Some patients suffered broken bones during seizures produced by electrical shock. Others lost much of their memory after shock treatments. Modern techniques employ general anesthesia, with ECT administered in controlled environments.

The 15-minute procedure occurs while the patient is unconscious, and muscles are relaxed via medication. Electrodes are placed on one or both sides of the head before a 30- to 60-second seizure is sparked by electrical current. Doctors do not understand how sparking brain activity treats depression, but believe it changes chemical functioning. Treatment usually takes place three times a week for about a month. Some patients see immediate improvement in depression, while others begin improving after two or three sessions.

In addition to depression, ECT might produce results treating severe mania. It sometimes works in patients in a heightened state of hyperactivity or euphoria as a symptom of bipolar disorder, which can lead to risky behavior, drug abuse, and psychosis. Shock therapy might also aid in the treatment of schizophrenia, obsessive-compulsive disorder, Parkinson’s disease, and epilepsy.

During electroconvulsive therapy for depression, heart rate and blood pressure increase. It can cause serious heart problems in patients with pre-existing heart disease. Some patients awake from ECT in a state of confusion, unable to identify where they are or what has happened. This side effect typically goes away within a few hours, but might last days, especially in older patients.

Retrograde amnesia might occur in some patients. They may be unable to recall what happened before the ECT treatment. This memory loss might go back days, weeks, or months. Nausea, vomiting, and muscle aches represent other side effects of shock therapy.