What is electroconvulsive therapy? Electroconvulsive therapy (ECT; also known as electroconvulsive therapy) is an extremely safe and effective medical treatment for certain psychiatric disorders. In this treatment, a quantitative electric current is passed through the scalp to cause a seizure in the brain. The treatment is painless because the patient is under general anesthesia in a drowsy state. Who should receive ECT? ECT has been used for over 60 years. In the United States, it is estimated that approximately 100,000 people are treated with ECT each year. Patients who have major depression, extreme mania, or certain schizophrenic disorders are usually best suited for ECT treatment. ECT is usually indicated when: other treatments are not effective; other treatments are not safe enough or are intolerable; the patient has had good results with previous ECT; and psychiatry or medicine considers ECT to be particularly important in the patient’s rapid and safe recovery. The use of medication or psychotherapy (talk therapy) does not result in improvement for all patients. In fact, when some disorders (such as depression) are very severe, psychotherapy alone is often not enough. For some patients, the medical risks of medication may be greater than the medical risks of ECT, especially for those with serious medical conditions, such as certain heart conditions. ECT is recommended when a patient has a life-threatening mental illness (e.g., suicidal ideation) because ECT is more effective than medication. Overall, most patients with depression who undergo ECT have significant outcomes. The majority of those patients who do not do well with medication also do well with ECT. All of this makes ECT the most effective treatment for depression. How is ECT performed? Before ECT, the patient’s medical condition is carefully evaluated, including medical history, physical examination, and medical laboratory tests if necessary. Treatment is usually performed three times a week, on Monday, Wednesday and Friday mornings. For a few hours prior to treatment, patients are asked to abstain from food and water and are not allowed to smoke. EEG sensors are placed in the head (EEG, which monitors brain activity) and other sensors in the chest (ECG). A cuff is wrapped around one arm to monitor blood pressure. Once all devices are connected, the anesthetic drug (sodium thiopental) is administered intravenously, which will produce a 5-10 minute sleep state in the patient. Once the patient is asleep, an intravenous muscle relaxant (succinylcholine chloride) is administered immediately. These prevent movement and only mild muscle contractions are present during the attack. When the patient is fully asleep, the muscles are fully relaxed and treatment begins. A brief electrical current is passed through electrodes on the scalp, which stimulates the brain and causes the seizure, lasting about one minute. Throughout the procedure, the patient is administered oxygen through a mask, which will continue until the patient regains voluntary breathing. At the end of the treatment, the patient will be transferred to the recovery area, where he or she will be monitored by professional staff, and after about 30-60 minutes, the patient will be able to leave the recovery area. How many treatments are required? ECT is a series of treatments. The full number of sessions to successfully treat a mental illness varies between patients. In depression, it usually takes 6-12 sessions, but some patients may need fewer sessions and some more. Is ECT effective? ECT is very effective in reducing the symptoms of mental illness. However, long-term ECT for psychiatric disorders is rarely done regardless of other treatments. To prevent relapse after ECT, most patients need further medication or ECT treatment. If ECT can prevent relapse, patients are usually treated with ECT on a regular basis in an outpatient setting. How safe is ECT? Statistically, the mortality rate of ECT is 1 in 10,000. Patients with serious medical conditions may have a slightly higher mortality rate, and ECT for psychiatric disorders has a lower mortality rate and serious medical complications than some drug treatments. Because of its high safety profile, ECT is often used to treat serious mental illnesses. With modern anesthesia techniques, fractures and dental complications are rare. What are the common side effects of ECT? The patient will feel disoriented when awake. This is partly due to the anesthesia and partly due to the treatment. This disorientation usually goes away after an hour. Some patients have headaches after treatment, which improve with pain medication, such as Tylenol or aspirin. Other side effects, such as nausea, last for a few hours at most, but rarely occur. Patients with heart disease, on the other hand, are at high risk for cardiac complications. Cardiac monitoring and other precautions, including the use of necessary medications, will contribute to the safety of the treatment. The most notable side effect of ECT is memory loss. there are two types of memory loss caused by ECT. The first type is rapid forgetting of new information, for example, just after treatment, the patient may not remember a conversation or what he or she has just read. A second type of memory loss is forgetting past events. Some patients will have memory gaps for events that occurred weeks and months ago, and occasionally, gaps will form for events that occurred years ago. this memory problem can also improve after ECT ends. However, some events may become permanent memory gaps, especially those that occurred prior to treatment. With any treatment, patients’ side effects vary, and memory loss is reported to be common. We know that the benefits of access to ECT do not include effects on memory. Many psychiatric disorders have impairments in attention and concentration. Therefore, when symptoms of mental illness improve after ECT, symptoms in thinking will also improve. soon after ECT is completed, most patients will have improved test scores in intelligence, attention and learning. Does ECT harm the brain? Scientific evidence suggests that there is no such possibility. Experimental animal studies have shown that brief episodes during ECT do not cause damage to the brain. In adults, it takes several hours for an attack to cause damage to the brain, but an ECT attack lasts only one minute, and brain scans after ECT show no damage, and the amount of electricity passing through the brain during ECT is minimal and does not cause damage. How does ECT work? As with some other medical treatments, the exact process of how ECT works is not well understood. We know that the effect of ECT depends primarily on the seizures within the brain and the technical factors that cause them. The biological changes that occur during the seizure are critical to the effect. Most researchers believe that the specific chemical changes within the brain induced by ECT are key to restoring normal function. A large number of studies are underway to analyze the biochemical processes that play a decisive role in this process.