What is Electroconvulsive Therapy? Electroconvulsive therapy (ECT) is a treatment in which a patient under general anesthetic will have an electrical current passed through his or her brain, causing a seizure in the brain. This therapy was developed in the 1930s and has become a painless, safe, effective therapy for a number of psychiatric problems.
How does Electroconvulsive Therapy work? When is ECT used? ECT is used primarily for depressive illnesses. It is usually reserved for situations where medications have not worked, but it may be the first choice of therapy for frailer, older patients for whom medications may be more of a problem. If a patient has responded well to ECT in the past, it may be his or her own first choice. ECT is also used occasionally in mania, schizophrenia, and in severe Parkinson's disease.How is the procedure carried out? Patients are treated in specific ECT suites or in hospital operating rooms. You will be given an intravenous line. Sensors monitoring your heart and brain waves will then be applied to your head, and you will be given a short-acting general anesthetic. Once you are asleep, you will be given a muscle relaxant. When you are completely asleep and your muscles are relaxed, a brief electrical current will applied to your brain either unilaterally (on one side), or bilaterally (on both sides). A brief seizure will follow, which will be modified by the muscle-relaxants so that medical staff may need to look carefully at brain wave monitors and observe your toe and hand movements to monitor it. The whole procedure takes only a few minutes. You will then be moved to a recovery area where a nurse will closely observe your pulse and blood pressure until you are awake enough to return to your room or go home.How many treatments are required? Usually patients with acute psychiatric problems require 6 – 12 treatments, given either 2 or 3 times a week. Occasionally more treatments will be required for maximum benefit.In order to keep patients well, outpatient maintenance ECT is sometimes recommended. In such cases the treating physician determines the number and frequency of treatments by assessing specific clinical problems and needs.What are the benefits of ECT? What are the side effects? Immediately after ECT, you may experience some nausea, headache, and muscle aches. These are most often managed by taking over the counter Tylenol. You may experience some acute confusion on the day of the ECT treatment, which most often resolves quickly. You may also forget recent events or events occurring around the time that you have the ECT. These memory problems are usually minor and may be decreased by slight changes in the procedure. Some patients experience longer-lasting problems with recalling memories from around the time of the ECT, and occasionally problems recalling some distant events. These memory effects generally subside once the ECT is completed. A few patients may have more severe problems remembering events from the distant past. Patients generally have fewer memory problems with unilateral ECT (one side of brain) compared to bilateral ECT (both sides of brain). Your treating psychiatrist will further explain this. You should always report possible side effects to your nurses or psychiatrist, so the treatment team can work to reduce them. ECT is considered very safe, and no more dangerous than a minor surgical procedure requiring a short general anesthetic. A current estimate of mortality in ECT is 2 in every 100,000 treatments. If you are worried about this, please discuss it with your psychiatrist.Patient Preparation for ECT Therapy: What will happen prior to the first ECT Treatment?
What will happen before, during and after each ECT Treatment? NIGHT BEFORE: Bath/Shower and Shampoo
Wearing Hospital Clothing: Is necessary to prevent soiling of personal clothing Remove Nail Polish and Make-up: This allows for better assessment of your physical condition during the anesthetic Jewelry: Please NO NOT bring valuables NOTHING to Eat or Drink after Midnight the Night Before, This includes candy, gum, & water. This is to prevent aspiration (choking) of food if vomiting occurs during or after treatment Treatment Time: You will be informed the day before of the time your treatment is scheduled Medication: Sometimes a medication will be given the night before and/or the monitoring of your treatment
he Morning of ECT Therapy *****NOTHING TO EAT OR DRINK until AFTER your Treatment*****
After ECT Therapy Recovery Room: Following your treatment you will be moved on a stretcher to the Recovery Room while still asleep. When you awaken you will find nurses in attendance who carry out the following procedures:
Inpatients: You will be returned to your room via wheelchair or stretcher Outpatients: You will be allowed to rest until you are fully awake Outpatients: Discharge Information – What do I Need to Know? You have had a general anesthetic and the effects persist for many hours. The following precautions are advised by your anesthetist and psychiatrist:
What are the Most Common Side Effects? Muscle Stiffness: caused by mediation given to relax your muscles Ways to relieve:
Headache: Can be caused by the anesthetic, by the treatment or being without food for an extended time. Ways to relieve: Have something to eat Take OTC medication or pain medication prescribed by your doctorUse relaxation tapes to reduce muscle tensionUse distraction techniques (counting, imagining) Rest in a dark room Apply a cold cloth to forehead
Nausea: Can be caused by the anesthetic or being without food for extended time. Take medication before nausea becomes too severe |