Electroconvulsive therapy (ECT)

Explains what electroconvulsive therapy is, what it is for and what happens during the treatment.

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What is ECT?

ECT (Electroconvulsive Therapy) is a treatment that involves sending an electric current through the brain to trigger an epileptic seizure to relieve the symptoms of some mental health problem.

The treatment is given under a general anaesthetic and using muscle relaxants, so that your muscles only twitch slightly, and your body does not convulse during the seizure.

What problems can ECT treat?

ECT is mainly used if you:

It may sometime be used if you:

  • are experiencing a manic or psychotic episode which is severe or is lasting a long time
  • are catatonic (staying frozen in one position for a long time; or repeating the same movement for no obvious reason; or being extremely restless, unrelated to medication)

It may also be used when it is important to have an immediate effect; for example, because you are so depressed that you are unable to eat or drink, and are in danger of kidney failure.

Is ECT effective?

No-one is sure how ECT works, but it is known to change patterns of blood flow in the brain, and also change the way energy is used in parts of the brain that are thought to be involved in depression. It may cause changes in brain chemistry, although how these are related to symptoms is not understood.

The ECT Accreditation Service (run by the Royal College of Psychiatrists) reported on a survey of 78 ECT clinics in England and Wales in 2012-2013. This reported the results of 1895 courses of treatment in 1789 people:

  • improved (‘minimally’, ‘much’ or ‘very much’): 1712
  • no change: 113
  • worse: 28

It didn't work overnight but as my course of nine progressed I could feel the huge weight of black, black fog lift from my mind.

Why is ECT controversial?

The history of ECT

In the past (1950s to 1970s), ECT was used far more than it is now. It was done without anaesthetic and often without consent, and far more treatments were given than is common now. Many people experienced it as more of a punishment than a treatment.

Some people think it is still administered in the same way, and it has also been depicted in quite barbaric ways on film. So people often have a false impression of what ECT is really like now.

Adverse effects

The main side effect is memory loss (which is also common after seizures caused by epilepsy). This is usually short-term, but can be very significant, disabling and long-lasting in some people and is a cause of anxiety.

Personal experiences

People’s experience of ECT varies enormously. Some people find it the most useful treatment they have had, and would ask for it again if they needed treatment for depression. Others feel violated by it, and would do anything to avoid having it again.

This information was published in June 2016. We will revise it in 2019.

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