Depression treatment - Electroconvulsive therapy

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Electroconvulsive therapy, more commonly known as "ECT," is a medical treatment performed only by highly skilled health professionals -- including doctors and nurses -- under the direct supervision of a psychiatrist, who is a medical doctor trained in diagnosing and treating mental illnesses.

Its effectiveness in treating severe mental illnesses is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health and similar organizations in Canada, Great Britain and many other countries.

The brain is an organ that functions through complex electrochemical processes, which may be impaired by certain types of mental illnesses. Scientists believe ECT acts by temporarily altering some of these processes.

ECT is typically used only for people who have severe depression and:

• are psychotic (have lost touch with reality)
• are suicidal
• haven't responded to other therapies
• can't take antidepressant medication. Older people often can't take antidepressants because of medical reasons but respond very well to ECT treatment

A course of treatment with ECT usually consists of six to twelve treatments given three times a week for a month or less.

Before an ECT treatment, the patient takes medicines that reduce the risk of side effects. For example, a drug called succinylcholine is usually given to block nerve impulses to skeletal muscles. This prevents the violent body movement that sometimes occured when ECT was administered in the past. The anesthesiologist will give the patient a general anesthetic before the treatment starts, so the person isn't conscious during the session. The patient awakens after five to ten minutes, much as he or she would from minor surgery.

According to the American Psychiatric Association, ECT helps about 80 to 85 percent of those who try it. Side effects include headaches, muscle ache or soreness, nausea and confusion, usually occurring during the first few hours following the procedure. Over the course of ECT, it may be more difficult for patients to remember newly learned information, though this difficulty disappears over the days and weeks following completion of the ECT course. Some patients also report a partial loss of memory for events that occurred during the days, weeks, and months preceding ECT.

While most of these memories typically return over a period of days to months following ECT, some patients have reported longer-lasting problems with recall of these memories. However, other individuals actually report improved memory ability following ECT, because of its ability to remove the amnesia that is sometimes associated with severe depression. The amount and duration of memory problems with ECT vary with the type of ECT that is used and are less a concern with unilateral ECT (where one side of the head is stimulated electrically) than with bilateral ECT.

ECT may be fatal for about one out of every 10,000 people.