Electroconvulsive Therapy (ECT)

Electroconvulsive Therapy (ECT) treatment involves administering, under anaesthetic, a series of electric shocks to the brain at intervals over a few weeks.  ECT has had something of a controversial history, and although it is not commonly used in contemporary medicine, some professionals believe that it has its place as an effective treatment in the small number of cases presenting with very severe or life threatening depression. 

There has been a fairly minimal amount of research completed using ECT as a form of treatment for mild to moderate depression, however, there has been extensive study of ECT and severely depressed hospitalised patients.  Research has rarely included children and adolescents due to fears that ECT may damage the developing brain. 

Improvements have been seen in tests using ECT in patients with psychotic depression, bipolar affective disorder and psychosis. 

In the past, key side effects of ECT have been:

• fracture 
• panic episodes 
• fear 
• spontaneous seizures and headaches

However, most of these are avoided now by using:

• anaesthesia 
• muscle relaxation techniques
• oxygenation 
• brief-pulse stimulating currents, selected electrode placement and energy dosing 

Recall and learning is often affected following ECT treatment.  Adults often have vague recollections of events and experiences that occurred during their illness and some patients report more persistent memory difficulties.

Generally speaking ECT is used as a 'last resort', especially on children and adolescents, and only after all other first-line therapies and treatments have failed to help.

References:

Australian National University 

Black Dog Institute

Half a Century of ECT Use in Young People
Joseph M. Rey, M.D., Ph.D., F.R.A.N.Z.C.P., Garry Walter, M.D., F.R.A.N.Z.C.P.
1997
 
Making Sense of ECT
Mind Publications
2003