About Electroconvulsive ("Shock") Therapy

Despite the bad press, electroconvulsive ("shock") therapy is one of the safest and most effective treatments for depression and mania, especially when those symptoms have not yielded to other forms of treatment, such as medications and psychotherapy.

Simply put, electroconvulsive therapy (ECT) uses electrical current, passed through the brain, to induce generalized seizures. These seizures, usually lasting between 25 and 150 seconds, seem to restore balance within the chemical makeup of the brain and decrease symptoms of serious mental illness.

Before ECT can be used, the patient must give informed consent. She must understand her illness, the exact nature and procedure of the treatment, the reasons for recommending ECT, alternative treatments and what will likely happen if she refuses ECT.

Then, a comprehensive evaluation is conducted, including psychiatric, medical and neurological assessments. Generally, the patient will undergo an electrocardiogram and complete blood analysis.

During the procedure, the patient receives a short-acting general anesthetic to prevent discomfort, a drug called a muscarinic anti-cholinergic, to dry secretions, and a skeletal muscle relaxant to block abrupt muscular convulsions and induce deep relaxation. Then two electrodes are situated either bilaterally (one on each side of the head around the temples) or unilaterally (both on the right side of the head, near the language center of the brain).

A patient receives treatment usually two to three times a week until symptoms are gone.
 
Last Updated: 12/16/2002
The Johns Hopkins University 1996-2003.  All rights reserved. This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation.