Although electroconvulsive therapy (ECT) was introduced nearly 70 years ago, the very mention of this therapy conjures frightening images and a negative emotional reaction. This form of treatment is much safer today compared to when it was introduced. However, the use of this therapy for the treatment of depression and other related mental illnesses still remains controversial.
It has been accepted that, in certain cases, it can be the best option as it provides fast and significant benefits. In the case of severe depression, where the risks of suicide are very high and antidepressants are not working, this form of treatment can help alleviate the symptoms.
ECT is used to induce therapeutic clonic seizures, wherein, the person loses consciousness and has convulsions for a minimum of 15 seconds. This is induced by passing electric currents through the brain. These seizures help increase the brain derived neurotrophic factor in patients who are resistant to drugs. This method is commonly recommended to patients who are suffering from severe depression accompanied with psychosis, refusal of food, or intent of suicide. This acute form of therapy is also helpful to people who are affected by schizophrenia and the medicines are not helpful.
The modern-day ECT machines have evolved a lot compared to the sine wave currents that were used initially. Machines these days deliver only a brief pulse current that causes very few cognitive effects. Usually, the electrical stimulus is about 800 mA and the current lasts between 1-6 seconds. These machines have been classified as Class III medical devices by the FDA.
There are several risks associated with this therapy that one has to consider before agreeing to this procedure for their loved one. The risks are similar to the effects of brief general anesthesia. Risks involved are:
- Memory Loss: An ECT can cause various types of memory loss. It can cause retrograde amnesia, in which the patient has trouble remembering the events which lead to the electroshock session. Usually, the patient has trouble remembering events a couple of weeks old, but in some cases, the memory loss can extend for a period of more than 2 years. Further, in some cases this condition is only temporary, while in some others it can be permanent.
- Cognitive Impairments: Immediately after the ECT, the patient may experience a brief period of confusion, and will have trouble placing people in his life. This condition is known as cognition, meaning impairment of the thought process and it can last for a few minutes or several hours. The more the number of ECT the patient undergoes, the longer will be the duration of these cognition periods.
- Medical Complications: During the process of ECT, the heart rate and the blood pressure increases and this can lead to serious heart problems. It is therefore very important that the doctor undertakes the pre-ECT evaluation very seriously, to avoid any complications after this therapy.
- Physical Problems: Immediately after this therapy, the patient may experience headache, jaw pain, or muscle pain, along with nausea and vomiting. It is very common and can be treated very effectively with the help of medicines.
Even though there are questions about the effectiveness of this therapy to treat mental illness and severe depression, it is believed that many chemical aspects of the brain functions are altered during and after the seizure activity that the therapy causes. Researchers have put forward the theory that, when ECT is used on a regular basis, the chemical changes reduce the symptoms of severe depression and other mental illness. This could be the reason as to why electroconvulsive therapy is most effective when used with other forms of treatments. It has been estimated that 80% of the people who have received a full course of ECT have benefited from it.