ECT

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ECT

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Overview

Electroconvulsive Therapy (ECT) is the oldest and most effective nonpharmacologic treatment for a number of psychiatric diseases including treatment refractory depression, bipolar depression, and some forms of psychosis. Our ECT service has decades of experience providing effective and compassionate care for a severely ill population.

Treated Conditions

  • Refractory Depression
  • Refractory Schizophrenia
  • Bipolar Depression
  • Obsessive Compulsive Disorder
  • Catatonia

FAQ

Electroconvulsive therapy (ECT) is a procedure in which a patient is placed under general anesthesia and also given a muscle relaxant. Once the patient is asleep, a small (less than 10 seconds) electrical current is sent to the brain to trigger a brief seizure. The entire treatment usually lasts no more than about fifteen minutes, with more time added for preparation and recovery. Because the patient is asleep and relaxed, their body does not have the shaking movements associated with a regular seizure, but their brain is able to respond to the effects of the electrical stimulus. The patient is monitored throughout by an anesthesiologist and a psychiatrist, and is connected to a cardiac monitor and EEG monitor to ensure safe and effective treatment. After the treatment is over, the patient wakes up in our recovery room and is closely monitored until they are fully awake and ready to return home.
Although ECT has been shown to be the most effective antidepressant treatment available since the mid-1930s, doctors do not know precisely how the treatments work. It is known that the seizures created by an ECT stimulus can alter brain chemistry, much as antidepressant medications are thought to do. It is possible that through repeated stimuli, ECT may flood the brain with neurotransmitters such as serotonin and dopamine, which are known to be involved in conditions like depression and schizophrenia. It may also promote changes in how neurons communicate with one another.
Because ECT has been around for so long, we have learned many important ways to make the process more comfortable, more tolerable, safer, and more effective for individuals. For instance, at Bay Psychiatric Associates|ECT, we use an individualized dosing schedule to make sure that each person receives the lowest stimulus necessary to have a positive effect. This minimizes side effects and ensures that treatment is tailored to the individual. We work closely with each person and with our anesthesia team to adjust anesthetic doses for patient comfort and treatment efficacy, and we are trained in a variety of techniques to deliver ECT in the most effective and comfortable means possible. We are happy to discuss all of these aspects of treatment and explore any questions with you during an initial consultation.
ECT can reverse symptoms of certain mental illnesses, sometimes quite quickly. ECT can be one of the fastest treatments to relieve symptoms for patients suffering from mania or severe depression. It is used to treat patients with severe depression, but may also be used for symptoms including delusions, hallucinations, or suicidal thinking. ECT may also be used for other neurological and psychiatric conditions, such as schizophrenia and Parkinson’s disease.

ECT is often given alongside other forms of treatment, including medication, psychotherapy, or others.

An acute course of treatments is usually around twelve treatments. At Bay Psychiatric Associates|ECT, we typically treat patients three times a week for an initial period of about four weeks. After this period, continuation or maintenance ECT, on a less frequent basis, can help solidify and maintain the response. Some patients may receive maintenance ECT on a weekly or monthly basis to prevent a relapse of depression or the underlying illness. At Bay Psychiatric Associates, one of our ECT specialist psychiatrists will work with you to determine an optimal personalized treatment course based on your needs and response to treatment.
ECT is a very safe and well studied procedure, however like any treatment, it does have some potential risks. People may have short-term memory loss or confusion, most typically for memories of events that occurred around the time of the ECT treatment. For most individuals, the short-term memory loss will disappear once the treatment ends, however there are a few people who have said that they have suffered long-term memory loss from ECT treatments.

Other side effects may include nausea, headaches or jaw pain, which can often be treated with medication.

Because ECT is a medical procedure, and anesthesia is involved, there are always risks of more severe medical complications. At Bay Psychiatric Associates, we require a pre-procedure medical screening to evaluate any conditions that may increase the risk for an individual patient.