Electroconvulsive Therapy (ETC)

West Oaks Hospital offers Electroconvulsive Therapy (ECT) for severely depressed patients. Though it may seem startling at first, ECT can be a very effective method of treatment when medication and therapy are not enough. The procedure is given to adults ages 18 and older two to three times a week, for six to 12 treatment sessions. ECT is most effective in major depression, where it has a beneficial effect for up to 90 percent of patients.

Patients undergo a physical and psychiatric evaluation to ensure that the treatments can be administered in the safest, most effective manner. Once the evaluation is completed the patient will be asked to schedule an appointment with their primary care provider to complete a history and physical and any tests identified by the physician. This information is sent to the ECT team for review prior to treatment being scheduled.

ECT FAQs

How does ECT work?

There are many ways ECT may work. It may be related to changing the brain cell network communications that can be over-connected in depression. ECT appears to increase neurotransmitters, such as serotonin and dopamine. ECT also increases brain-derived neurotrophic factor (BDNF) which can help brain cells grow.

What happens during an ECT procedure?

ECT patients are asked not to eat or drink anything from midnight the night before the procedure until after their ECT treatment is completed the following day. The morning of ECT, patients arrive to the waiting area and generally complete a clinical survey. The patient then enters the ECT suite and meets with the nurse, psychiatrist, and anesthesiologist.

During the procedure, the patient receives a brief-acting anesthetic, which puts the patient to sleep for approximately 7 minutes. A muscle relaxant is given shortly after the anesthesia to loosen the patient’s muscles to prevent muscle spasms. Patients wake up several minutes after the procedure stops. Patients are then transferred to the recovery area. They stay until blood pressure and alertness have returned to normal, which usually takes about 20 minutes.

Do patients need to take antidepressants with ECT?

ECT eliminates a depressive episode in over 55 percent of patients with a marked reduction in depression in another 20 to 30 percent of patients. ECT remains the most effective antidepressant treatment, with a greater response rate than antidepressant medication. Although ECT is effective in the short-term to get out of depression, patients can relapse quickly, sometimes within months or weeks if they are not taking antidepressant medication during and after ECT. For this reason, we request patients take antidepressant medication during and after ECT.

Can patients drive after ECT?

Patients are not allowed to drive during the entire ECT course and for two weeks after the last treatment in an acute series of ECT. An acute series is usually three treatments a week for six to 12 treatments. Patients who receive maintenance ECT can drive except on the day of ECT.

What are common side-effects of ECT?

The immediate side effects of the procedure may include:

  • Headaches, which are commonly relieved with ice packs and ibuprofen after ECT. If that doesn’t help, Toradol IV may be added at the next ECT treatment to prevent headache.
  • Nausea – IV Zofran may be added at the next ECT procedure to prevent nausea.
  • Muscle aches – tend to occur in the first and second treatments and tend to resolve thereafter.
  • Disorientation and confusion – Some patients develop memory problems associated with ECT. Memories developed around the time of ECT have a greater chance of not being recalled while those formed long before ECT generally are not altered. The ability to form new memories can be impaired during and after an acute series of ECT treatments but this ability makes a full recovery in about two weeks from the last treatment.

 

There are risks associated with any treatment procedure and individual results may vary. Please consult the dedicated professionals within the ECT program at West Oaks Hospital to assess if you are a candidate for ECT treatment. Our Medical Staff will also consult with you on the risks and benefits of ECT treatment if you are a suitable candidate.