ECT is a safe and effective clinical procedure for conditions that do not respond as well to other forms of treatment. The patients who receive ECT usually have not responded well to anti-depressant medications or are unable to take them for a medical reason. According to the National Institute of Mental Health (NIMH), 80-90% of people with severe depression improve dramatically with ECT.
Before a patient receives ECT treatments, the physician completes an evaluation. The evaluations includes an assessment of previous forms of treatment and response, an EKG (electrocardiogram), an MRI, a series of x-rays, blood and urine tests, and a standard physical exam and medical history. These procedures screen the patient for any medical problems which might rule out ECT as a treatment. The patient and family have an opportunity to discuss ECT with the physician and a nurse from the ECT unit. After questions or concerns are answered, the patient then signs a consent form before treatments begin.
Patients are given a general anesthetic, which wears off quickly. While asleep, a mild electrical current is administered, which makes the patient have a brief seizure. During this time, the patient is closely observed and monitored by the ECT psychiatrist, the anesthesiologist and the registered nurse. Heart and brain wave patterns are closely monitored during the procedure. After a few moments the patient awakens and is taken to the recovery room where a nurse continues to check the patient closely for another 30 minutes. When patients are fully awake and stable, they eat a small snack and are released. Repeated treatments are necessary to achieve the most complete antidepressant response.
No, ECT is not painful and is very safe. People are often frightened by stories they hear about "shock treatments," but ECT is given under carefully controlled conditions and there is very little risk. The patient does not feel anything except the IV for anesthesia. The risk involved in ECT is about the same as any procedure involving general anesthesia. The risk is minimized by the thorough evaluation, which is done before the procedure. After ECT treatment, the patient may feel some brief confusion and may have difficulty remembering events. This is common. For most patients this clears within a few hours and is not a long-term problem. The length of time the memory loss lasts varies among patients.